Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 16.000432 | CT |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 341649 | NY |
NPI | 1164950143 |
---|---|
Provider Name | Ximena Rossato-Bennett |
First Address | Danbury, CT 06810-6032 |
Second Address | Danbury, CT 06810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2017 |
Last Update Date | 17/05/2018 |