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Individual

MR. PATRICK LYNN GAGNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
80 E BROADWAY APT D, MILFORD, CT 06460-6120
(203) 815-0691
(203) 815-0691
Mailing address
3017 MAIN ST, STRATFORD, CT 06614-4977
(203) 815-0691
(203) 873-6845

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
000894
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004174843
CT
Enumeration date
03/16/2007
Last updated
02/26/2018
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