Individual
GRACE CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
61 POMEROY AVE UNIT 1, MERIDEN, CT 06450-7483
(203) 694-5340
Mailing address
1290 SILAS DEANE HWY FL 1, WETHERSFIELD, CT 06109-4337
(860) 972-6970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66551
CT
Other
Enumeration date
04/21/2016
Last updated
09/02/2020
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