Individual
MARY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
114 WOODLAND ST, DEPARTMENT OF SURGERY, HARTFORD, CT 06105-1208
(860) 714-5237
Mailing address
71 MEADOWCREST LN, WATERTOWN, CT 06795-2406
(860) 417-8239
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/20/2016
Last updated
08/23/2024
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