Individual
MANUEL PABOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20 YORK ST, SOUTH PAVILION 218, NEW HAVEN, CT 06510-3220
(203) 688-2222
Mailing address
464 CONGRESS AVE, SUITE 260, NEW HAVEN, CT 06519-1361
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3825
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/13/2017
Last updated
06/22/2017
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