Individual
SANGMO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
263 FARMINGTON AVE, GERIATRICS ASSOCIATES MC 6232 UCONN HEALTH CTR, FARMINGTON, CT 06032-1956
(860) 679-3958
Mailing address
20 STEVEN ST, APARTMENT C, WEST HARTFORD, CT 06110-2620
(203) 695-8498
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/25/2012
Last updated
07/05/2012
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