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Individual

KATHRYN PASCUCCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1340 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2754
(860) 644-6676
(860) 648-9501
Mailing address
1340 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2754
(860) 644-6676
(860) 648-9501

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
050725
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050725
CT STATE LICENSE
CT
Enumeration date
01/26/2011
Last updated
06/08/2012
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