Individual
IRSA AMIN WENCESLAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9329
Mailing address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9329
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11885
CT
Other
Enumeration date
04/25/2023
Last updated
11/20/2023
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