Organization
THE MODERN WOMAN HEALTH & WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVANNA SUBRAMANI-GONZALEZ DNP-FNPC (CMO / OWNER)
(203) 725-5339
Entity
Organization
Contact information
Practice address
504 WOLCOTT RD STE C, WOLCOTT, CT 06716-2462
(203) 504-9507
Mailing address
504 WOLCOTT RD STE C, WOLCOTT, CT 06716-2462
(203) 504-9507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
03/29/2023
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