Individual
AMANDA TISSOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 739-6378
Mailing address
103 NEWTOWN RD, DANBURY, CT 06810-4195
(203) 730-8789
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
68813
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2017
Last updated
06/21/2021
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