Organization
CT CENTER FOR BLADDER HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALISON JOAN GORMAN APRN (OWNER)
(860) 670-3039
Entity
Organization
Contact information
Practice address
136 HAZARD AVE BLDG 6, ENFIELD, CT 06082-4520
(860) 670-3039
Mailing address
20 N MEADOW RD, WINDSOR, CT 06095-2524
(860) 670-3039
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
004196
CT
Other
Enumeration date
06/25/2012
Last updated
07/24/2012
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