Individual
IFEYINWA LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 INDIAN RIVER RD, ORANGE, CT 06477-3649
(203) 497-3861
Mailing address
31 KINGSTON ST, WETHERSFIELD, CT 06109-1317
(860) 718-5061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8604
CT
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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