Individual
IDA R PRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
1000 LAFAYETTE BLVD STE 1100, BRIDGEPORT, CT 06604-4710
(475) 301-8414
(203) 745-4595
Mailing address
40 PUTNAM AVE UNIT 6535, HAMDEN, CT 06517-7722
(475) 301-8414
(203) 745-4595
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
19793616
CT
376K00000X
Nurse's Aide
NA198508
CT
Other
Enumeration date
07/02/2013
Last updated
01/27/2023
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