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Individual

EMILY ROSE STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
339 HEMINGWAY AVE, EAST HAVEN, CT 06512-5341
(203) 468-9775
Mailing address
15 SANDRA DR, BRANFORD, CT 06405-6137
(203) 464-1909

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003640
CT
363A00000X
Physician Assistant

Other

Enumeration date
08/17/2016
Last updated
11/15/2021
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