Individual
KARIN M KOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-6227
(860) 679-8080
(860) 679-1420
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-8082
(860) 679-2626
(860) 679-1223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002358
CT
363AS0400X
Surgical Physician Assistant
002358
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083948574
—
CT
Enumeration date
09/30/2009
Last updated
07/11/2022
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