Individual
LAUREN DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 FRANKLIN ST STE 1, WATERBURY, CT 06706-1281
(203) 709-6000
Mailing address
260 MALLARD DR E, NORTH WALES, PA 19454-1197
(267) 885-8695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
4284
CT
Other
Enumeration date
07/17/2018
Last updated
09/21/2020
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