Individual
DR. I-SANNA R. GIBBONS-FIDELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06102-5037
(860) 972-2249
(860) 282-0170
Mailing address
99 E RIVER DR FL 5, EAST HARTFORD, CT 06108-7301
(860) 972-2249
(860) 282-0170
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35138411
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
74292
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440391
—
OH
Enumeration date
06/20/2016
Last updated
05/17/2023
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