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General NPI Number Information
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NPI Number | 1447433677
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Entity Type | Organization
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Legal Business Name | FIGNAR FAMILY PRACTICE, LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 15 PALOMBA DR SUITE 5
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City | ENFIELD
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State | CT
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Zip | 06082-3888
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Country | US
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Telephone | 860-745-1623
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Fax | 860-741-3618
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Provider Business Mailing Address
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Address Line | 15 PALOMBA DR SUITE 5
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City | ENFIELD
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State | CT
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Zip | 06082-3888
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Country | US
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Telephone | 860-745-1623
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Fax | 860-741-3618
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY ALAN FIGNAR
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Credential | M.D.
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Telephone | 860-745-1623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002009
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001809
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 040711
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License Number State | CT
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