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General NPI Number Information
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NPI Number | 1891899464
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Entity Type | Individual
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Provider Name | JOHN BYRNE GARVEY MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15 MOHEGAN AVE
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City | NEW LONDON
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State | CT
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Zip | 06320-8100
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Country | US
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Telephone | 860-437-3611
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Fax | 860-437-1801
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Provider Business Mailing Address
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Address Line | 153 HIGH ST APT 18
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City | WESTERLY
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State | RI
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Zip | 02891-1787
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Country | US
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Telephone | 401-596-1306
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 039227
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License Number State | CT
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