Individual
MINERVA MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
910 WOLCOTT ST, WATERBURY, CT 06705-1317
(203) 759-1611
(203) 759-1707
Mailing address
910 WOLCOTT ST, WATERBURY, CT 06705-1317
(203) 759-1611
(203) 759-1707
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1814
CT
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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