Individual
GINA WASSEF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
613 BROAD ST, NEW LONDON, CT 06320-2544
(860) 442-0669
Mailing address
613 BROAD ST, NEW LONDON, CT 06320-2544
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0013287
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154332641
—
CT
Enumeration date
08/18/2017
Last updated
06/16/2018
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