Individual
COLLEEN FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 701-6999
Mailing address
115 PLANT ST, NEW LONDON, CT 06320-4423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/26/2020
Last updated
09/28/2022
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