Organization
PATRICK GAGNON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GAGNON APRN (OWNER)
(475) 225-0537
Entity
Organization
Contact information
Practice address
3017 MAIN ST, STRATFORD, CT 06614-4977
(475) 225-0537
(203) 439-2087
Mailing address
3017 MAIN ST, STRATFORD, CT 06614-4977
(475) 225-0537
(203) 439-2087
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
000894
CT
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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