Individual
MARYKATE PESTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
56 FRANKLIN ST STE 1, WATERBURY, CT 06706-1281
(203) 709-6000
Mailing address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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