Individual
LEAH BUENEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 WILLOW ST, MYSTIC, CT 06355-2636
(860) 572-6868
Mailing address
4 WINDWARD LN, OLD LYME, CT 06371-1861
(410) 310-3021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3372
SC
363A00000X
Physician Assistant
Primary
5639
CT
Other
Enumeration date
11/11/2019
Last updated
04/08/2022
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