Individual
COURTNEY FANKHANEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
15 HODIO DR, ANSONIA, CT 06401-2643
(203) 906-7231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002225
CT
Other
Enumeration date
04/02/2009
Last updated
05/01/2009
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