Individual
MRS. JACLYN LEIGH ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 CHAPEL ST, NEW HAVEN, CT 06511-4411
(203) 865-3852
Mailing address
17 STONEWALL LN, CLINTON, CT 06413-2531
(203) 996-6671
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
080069
CT
Other
Enumeration date
09/29/2011
Last updated
11/19/2014
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