Individual
IDAYAT OBISESAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 BOSTON AVE, STRATFORD, CT 06614-5211
(929) 336-9455
Mailing address
250 BOSTON AVE, STRATFORD, CT 06614-5211
(929) 336-9455
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CT
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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