Individual
JUDITH CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, GASTROENTEROLOGY ASSOCIATES, FARMINGTON, CT 06030-0001
(860) 679-3238
(860) 679-1217
Mailing address
65 KANE ST, PROVIDER ENROLLMENT, 2ND FLOOR, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
000552
CT
364SM0705X
Medical-Surgical Clinical Nurse Specialist
000552
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4223442
—
CT
Enumeration date
10/03/2005
Last updated
01/25/2010
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