Individual
LEONARDO LEWIS FARIN-MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 TROUT AVE, BLDG. 86, NUMI, NAVAL SUBMARINE BASE, NEW LONDON, GROTON, CT 06349-5159
(860) 694-2876
Mailing address
PO BOX 159, NAVAL SUBMARINE BASE, NEW LONDON, GROTON, CT 06349-5159
(860) 964-2876
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/11/2012
Last updated
06/06/2012
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