Last, Gary Lee

Last, Gary Lee is an individual health care provider with primary practice located at 580 Cottage Grove Rd Suite 207, Bloomfield CT 06002-3088. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Last, Gary Lee can be contacted via phone (860) 242-8644.

Contact Information

Primary practice address
580 Cottage Grove Rd Suite 207 Bloomfield CT 06002-3088
Phone: (860) 242-8644
Fax: (860) 242-5017
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 23605 Connecticut

Profile Details

NPI number 1629003918
LBN Legal business name Last, Gary Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629003918 NPPES
Connecticut Other 0100236Q5CT01 BLUE SHIELD
Connecticut MEDICAID 0012360581 BLUE SHIELD

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