Basic Information
| Provider Information | |||||||||
| NPI: | 1265773139 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VERA | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RESPIRATORY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 FAIRVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | NAUGATUCK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067704011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035659936 | ||||||||
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| Practice Location | |||||||||
| Address1: | 84 PROGRESS LN | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067053863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037537778 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2013 | ||||||||
| LastUpdateDate: | 03/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2278H0200X | 001885 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health |
No ID Information.