Individual
JUSTINE LAUREN VANACORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
410 SAYBROOK RD STE 100, MIDDLETOWN, CT 06457-4780
(860) 685-8940
Mailing address
410 SAYBROOK RD STE 100, MIDDLETOWN, CT 06457-4780
(860) 685-8940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015773
NY
Other
Enumeration date
07/23/2012
Last updated
02/24/2020
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