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General NPI Number Information
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NPI Number | 1144211616
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Entity Type | Individual
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Provider Name | GARY J PRICE MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 5 DURHAM RD BLDG# 1, SUITE 8
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City | GUILFORD
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State | CT
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Zip | 06437-2076
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Country | US
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Telephone | 203-453-6635
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Fax | 203-458-7580
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | GUILFORD
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State | CT
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Zip | 06437-0368
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Country | US
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Telephone | 203-453-6635
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Fax | 203-458-7580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 023634
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License Number State | CT
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