Individual
DR. HENRY JINGYUAN FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34 MAPLE STREET, NORWALK, CT 06850-3815
(203) 852-2023
Mailing address
515 WEST AVE, NB421, NORWALK, CT 06850
(347) 556-3878
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
03/07/2023
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