Individual
MISS ITORO JOSEPH ETIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
816 BROAD ST, MERIDEN, CT 06450-4350
(203) 238-1125
Mailing address
547 N ELM ST, WALLINGFORD, CT 06492-3268
(860) 508-8587
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11263
CT
Other
Enumeration date
11/23/2022
Last updated
03/20/2023
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