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Individual

MALLORY MEGAN MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
80 SEYMOUR STREET, CARDIOLOGY DEPT, HARTFORD, CT 06102-5037
(860) 899-8078
Mailing address
80 SEYMOUR STREET, CARDIOLOGY DEPT, HARTFORD, CT 06102-5037
(860) 899-8078

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3885
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
003885
CT

Other

Enumeration date
08/29/2008
Last updated
10/10/2017
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