Individual
LORINA PETTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 396-1129
Mailing address
594 BIRMINGHAM ST, BRIDGEPORT, CT 06606-3348
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
10.174564
CT
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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