Individual
WANDA JUARROS HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
64 BLACK ROCK AVE, BRIDGEPORT, CT 06605-1200
(203) 576-3885
Mailing address
514 AMERICAS WAY # 12464, BOX ELDER, SD 57719-7600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26518
AZ
207Q00000X
Family Medicine Physician
Primary
82035
CT
207Q00000X
Family Medicine Physician
MD60621875
WA
Other
Enumeration date
05/26/2006
Last updated
06/13/2025
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