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Individual

MS. LEE SIUZDAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1106 NORTH AVE, BRIDGEPORT, CT 06604
(475) 225-8010
Mailing address
703 THIRD AVE, WEST HAVEN, CT 06516

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
004587
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
004587
CT

Other

Enumeration date
01/11/2011
Last updated
06/13/2016
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