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Individual

DR. MARY GRIFFIN KELLOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, IBCLC

Contact information

Practice address
2505 MAIN ST, SUITE 223, STRATFORD, CT 06615-5839
(203) 375-5812
Mailing address
540 BARN HILL RD, MONROE, CT 06468-1419
(203) 268-3856

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
035447
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001354472-02
CT
Enumeration date
10/25/2006
Last updated
07/08/2007
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