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Individual

MISS ANNE DELANCEY SOUTHALL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
24 STEVENS ST, DEPARTMENT OF SURGERY, NORWALK, CT 06850-3852
(203) 852-2000
Mailing address
24 LOWER TRINITY PASS RD, POUND RIDGE, NY 10576-2121
(914) 764-0733

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001526
CT
363A00000X
Physician Assistant
PA761
ME

Other

Enumeration date
02/21/2006
Last updated
07/08/2007
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