Individual
JULIANNE YANTACHKA ICATAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
89 HART ST, BRIDGEPORT, CT 06606-5048
(203) 579-2229
Mailing address
15 PROWITT ST, NORWALK, CT 06855-1203
(203) 299-0792
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
039643
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001396432
—
CT
Enumeration date
10/16/2006
Last updated
12/04/2009
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