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General NPI Number Information
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NPI Number | 1619963857
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Entity Type | Individual
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Provider Name | JONATHAN D. GETZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 114 WOODLAND ST DEPARTMENT OF RADIOLOGY
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City | HARTFORD
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State | CT
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Zip | 06105-1208
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Country | US
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Telephone | 860-714-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 ASYLUM AVE SUITE 3201E
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City | HARTFORD
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State | CT
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Zip | 06105-1770
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Country | US
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Telephone | 860-714-2724
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 034563
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 03-4563
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License Number State | CT
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