Individual
DR. LAURIE-ANN NESSRALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
267 GRANT ST, BRIDGEPORT HOSPITAL, BRIDGEPORT, CT 06610-2805
(203) 384-3072
Mailing address
7365 MAIN ST, SUITE 310, STRATFORD, CT 06614-1300
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36642
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366427
—
CT
01
—
36642
CONNECTICARE
CT
01
—
500HBA011CT01
BCBS CT
CT
01
—
5748143
AETNA CT
CT
Enumeration date
05/22/2006
Last updated
07/08/2007
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