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Individual

DEANN MASTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
171 GRANDVIEW AVE, SUITE 201, WATERBURY, CT 06708-2517
(203) 578-4630
(203) 578-4629
Mailing address
71 HAYNES ST, SUITE 1221, MANCHESTER, CT 06040-4131
(860) 533-6595
(960) 533-6594

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2035
CT
363AS0400X
Surgical Physician Assistant
002035
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1062414
NCCPA
CT
Enumeration date
11/28/2007
Last updated
01/14/2015
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