NPI Code Detail JSON Logo

1720068679 NPI number — RAFAEL P SQUITIERI MD

NPI Number: 1720068679
Health Care Provider/Practitioner: RAFAEL P SQUITIERI MD

Information about “1720068679” NPI (RAFAEL P SQUITIERI MD) exists in 1720068679 in HTML format HTML  |  1720068679 in plain Text format TXT  |  1720068679 in PDF (Portable Document Format) PDF  |  1720068679 in an XML format XML  formats.

NPI Number : 1720068679 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720068679",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SQUITIERI",
    "FirstName": "RAFAEL",
    "MiddleName": "P",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1177 SUMMER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STAMFORD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06905-5572",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-576-5708",
    "MailingAddressFaxNumber": "203-367-8392",
    "FirstLinePracticeLocationAddress": "2800 MAIN STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRIDGEPORT",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06606",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-576-5708",
    "PracticeLocationAddressFaxNumber": "203-367-8392",
    "EnumerationDate": "01/18/2006",
    "LastUpdateDate": "11/06/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208G00000X",
          "TaxonomyName": "Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician",
          "LicenseNumber": "039409",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207RC0000X",
          "TaxonomyName": "Cardiovascular Disease Physician",
          "LicenseNumber": "039409",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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