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Individual

AVA ROSE BOORNAZIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-6000
(203) 709-8849
Mailing address
56 FRANKLIN ST, 3RD FLOOR, WATERBURY, CT 06706-1221
(203) 709-8873
(203) 709-8689

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
002444
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004213253
CT
Enumeration date
06/25/2006
Last updated
10/19/2021
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