Individual
AIDALIZ VIZCAINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5065 MAIN ST, TRUMBULL, CT 06611-4204
(203) 873-2014
Mailing address
5065 MAIN ST, TRUMBULL, CT 06611-4204
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
PTN.0011180
CT
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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