Individual
LUCINDA GILLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
335 BROAD ST, MANCHESTER, CT 06040-4036
(860) 293-3101
Mailing address
8 VALLEY VIEW DR, BLOOMFIELD, CT 06002-1632
(860) 242-4439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001075
CT
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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