Individual
MRS. TERRI DICLEMENTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 725-1498
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 725-1498
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
020021
NY
363AS0400X
Surgical Physician Assistant
Primary
4615
CT
Other
Enumeration date
08/19/2016
Last updated
01/02/2020
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