Individual
SURAYDA JULISSA HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
5 FOUNDERS ST STE 100, WILLIMANTIC, CT 06226-2049
(860) 423-9764
(860) 724-2580
Mailing address
457 STANLEY DR, GLASTONBURY, CT 06033-2623
(516) 410-4367
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TL.0005341
CO
Other
Enumeration date
06/13/2014
Last updated
05/22/2024
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