Individual
JENNIE B NALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
761 MAIN AVE, SUITE 102, NORWALK, CT 06851-1080
(203) 810-4151
(203) 810-4150
Mailing address
761 MAIN AVE, SUITE 102, NORWALK, CT 06851-1080
(203) 810-4151
(203) 810-4150
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
045804
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045804
CT LICENSE
CT
Enumeration date
08/30/2007
Last updated
05/21/2009
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