Individual
AVITAL GREENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06106-3315
(860) 545-5000
Mailing address
299 MILE CREEK RD, OLD LYME, CT 06371-1815
(860) 373-6508
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9875
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2021
Last updated
08/19/2021
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