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Individual
THOMAS HEFFERNAN
Active
Individual
THOMAS HEFFERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-0640714
GRIFFIN HOSPITAL TAX ID
CT
Enumeration date
11/07/2008
Last updated
11/07/2008
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