Provider Information for 1952322711
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DENNIS JAY GOTTFRIED MD
Sex: Male
NPI: 1952322711
Last Updated: 2022-09-29
Certification Date: 2021-12-02
Certification Date: 2021-12-02
Details
| Name | Value | ||||||||||||||
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| NPI | 1952322711 | ||||||||||||||
| Enumeration Date | 2006-07-21 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 895 E MAIN ST TORRINGTON, CT 06790-3918 United States Phone: 860-489-1291 | Fax:860-489-1804 | ||||||||||||||
| Primary Practice Address | 895 E MAIN ST TORRINGTON, CT 06790-3918 United States Phone: 860-489-1291 | Fax:860-489-1804 | ||||||||||||||
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