Individual
SOPHIE MASTERNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2100
(860) 679-4815
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
001349
CT
363LW0102X
Women's Health Nurse Practitioner
1349
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1349
CT STATE LICENSE
CO
Enumeration date
11/07/2006
Last updated
02/05/2016
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