Individual
KYLE SURPRENANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
91 ELM ST APT 210A, MANCHESTER, CT 06040-8603
(603) 233-9767
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
23.006230
CT
Other
Enumeration date
06/19/2023
Last updated
08/11/2023
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