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Individual

SUSAN ST. JACQUES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3011
Mailing address
33 N MARK DR, OXFORD, CT 06478-1565
(203) 888-7644

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000445
CT

Other

Enumeration date
06/11/2006
Last updated
10/11/2007
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