Individual
MRS. KATHERYN E GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 444-5104
Mailing address
11 CAPE ANN CT, NEW LONDON, CT 06320-3701
(860) 912-0762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002827
CT
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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