Individual
JAMES TAVORNWATTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(718) 593-1761
Mailing address
64 ROBBINS ST, WATERBURY, CT 06708-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
069841
CT
Other
Enumeration date
03/21/2019
Last updated
08/25/2022
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