Stack, Gary E
Stack, Gary E is an individual health care provider with primary practice located at 800 Howard Ave Yale Physicians Building, New Haven CT 06519-1369. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine is his primary health care specialty. Stack, Gary E can be contacted via phone (203) 785-2140.Contact Information
Primary practice address
800 Howard Ave Yale Physicians Building
New Haven CT 06519-1369
Phone: (203) 785-2140
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine | 207ZB0001X | 031831 | Connecticut |
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 031831 | Connecticut |
Profile Details
| NPI number | 1982687463 |
|---|---|
| LBN Legal business name | Stack, Gary E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Jul 27th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982687463 | NPPES |
| Connecticut | MEDICAID | 001318311 |
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