Individual
ALICIA D FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
34 MAPLE ST, NORWALK, CT 06850-3894
(203) 852-2188
Mailing address
34 MAPLE ST, NORWALK, CT 06850-3894
(203) 852-2188
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6321
CT
Other
Enumeration date
06/22/2023
Last updated
10/28/2023
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