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Contact Information

GARY L LAST, MD
580 COTTAGE GROVE RD
SUITE 207
BLOOMFIELD, CT06002-3088
 Phone: 860-242-8644
 Fax: 860-242-5017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for GARY L LAST · (Male)

NPI Number 1629003918
Status Active
Credentials MD
Entity Individual
Enumeration date 07/12/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 23605
  • CT Medicaid 0012360581
  • CT Other 0100236Q5CT01 BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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