Individual
BERTILLE KUISSO PONKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 SAINT GEORGE SQUARE CT STE 300, WINSTON SALEM, NC 27103-1368
(203) 683-5946
(203) 306-4040
Mailing address
1000 LAFAYETTE BLVD STE 1100, BRIDGEPORT, CT 06604-4710
(203) 683-5946
(203) 306-4040
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
05/07/2020
Last updated
11/27/2023
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