Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 033379 | CT |
Y | 207VE0102X | Reproductive Endocrinologist | 033379 | CT |
NPI | 1548779861 |
---|---|
Provider Name | Tony Gebran Zreik |
First Address | Hamden, CT 06514-1529 |
Second Address | New Haven, CT 06510-3220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2017 |
Last Update Date | 29/09/2017 |