Individual
STEPHANIE KYC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARK ST, NEW HAVEN, CT 06504-8901
(203) 688-2320
Mailing address
1 PARK ST, NEW HAVEN, CT 06504-8901
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
298258
NY
208000000X
Pediatrics Physician
Primary
72133
CT
2080N0001X
Neonatal-Perinatal Medicine Physician
298258
NY
Other
Enumeration date
04/12/2013
Last updated
08/18/2022
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