Individual
KIDAN KIDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 MAIN ST, MIDDLETOWN, CT 06457-2732
(860) 347-6971
Mailing address
675 MAIN ST, MIDDLETOWN, CT 06457-2732
(860) 347-6971
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2024
Last updated
04/20/2024
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