Individual
IDAIRA AGUILAR TEJEDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
99 HAWLEY LN STE 1120, STRATFORD, CT 06614-1208
(203) 377-5988
Mailing address
99 HAWLEY LN STE 1120, STRATFORD, CT 06614-1208
(203) 377-5988
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
64181
CT
2084N0400X
Neurology Physician
64181
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/22/2014
Last updated
08/17/2020
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