Individual
KIMBERLY JOY WAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2800 MAIN STREET, BRIDGEPORT, CT 06606
(203) 382-2350
(475) 210-3025
Mailing address
2800 MAIN STREET, BRIDGEPORT, CT 06606
(203) 382-2350
(475) 210-3025
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5498
CT
Other
Enumeration date
01/12/2019
Last updated
05/24/2024
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