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Individual

KARA MIGNOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 446-8265
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 446-8265

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000724
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4024972
CT
05
4041679
CT
Enumeration date
09/29/2006
Last updated
07/09/2007
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