Individual
MONICA MASSABNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 290-4142
Mailing address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
(860) 528-1359
(860) 290-4142
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002084
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002084
LICENSE
CT
01
—
11916883
CAQH
CT
Enumeration date
05/13/2008
Last updated
09/27/2013
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