Individual
NOVA MCNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 WAUREGAN RD, BROOKLYN, CT 06234-1925
(860) 779-9308
Mailing address
PO BOX 706, BROOKLYN, CT 06234-0706
(860) 779-9308
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
002851
CT
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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