Individual
NA NIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
310 CEDAR ST, NEW HAVEN, CT 06510-3218
(203) 785-6363
Mailing address
310 CEDAR ST # LH108, NEW HAVEN, CT 06510-3218
(203) 785-6363
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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