Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 53773 | CT |
NPI | 1013144369 |
---|---|
Provider Name | Tracy E Patel |
First Address | Bloomfield, CT 06002-3060 |
Second Address | Bloomfield, CT 06002-3060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2009 |
Last Update Date | 20/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008057707 | (05) | CT |
P01712133 | RAILROAD MEDICARE (01) | CT |