Individual
DANIELLE RENEE LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-9638
Mailing address
1050 STATE ST APT 403, NEW HAVEN, CT 06511-2773
(604) 481-1419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4376
CT
363AM0700X
Medical Physician Assistant
4376
CT
Other
Enumeration date
02/13/2019
Last updated
02/13/2019
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