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JOHN HENDRIAN WHITBECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
172 MT PLEASANT ROAD, NEWTOWN PROFESSIONAL CENTER, NEWTWON, CT 06470
(203) 426-8442
Mailing address
172 MT PLEASANT ROAD, NEWTOWN PROFESSIONAL CENTER, NEWTWON, CT 06470
(203) 426-8442

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002023
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002023
PA LICENSE
CT
Enumeration date
12/27/2007
Last updated
12/27/2007
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