Individual
JORDAN ANIEL DORELUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMSC
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
175 SEATON RD APT 4, STAMFORD, CT 06902-3216
(203) 685-5401
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23.006496
CT
Other
Enumeration date
01/26/2024
Last updated
03/06/2024
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