Individual
TERRI J DVORKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
166 WATERBURY RD, STE 300, PROSPECT, CT 06712
(203) 758-0878
(203) 758-0877
Mailing address
166 WATERBURY RD, STE 300, PROSPECT, CT 06712
(203) 758-0878
(203) 758-0877
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001762
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400001762CT
BCBS
—
Enumeration date
03/16/2006
Last updated
10/19/2011
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