Individual
CASSIDY ELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(203) 694-8200
Mailing address
1376 OLD WATERBURY RD, SOUTHBURY, CT 06488-1910
(203) 264-8939
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
185458
CT
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/21/2018
Last updated
12/08/2023
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