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Individual

KATHRYN J CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
52 HAZELNUT HILL RD, GROTON, CT 06340-3268
(860) 446-8265
Mailing address
52 HAZELNUT HILL RD, GROTON, CT 06340-3268
(860) 446-8265

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000064
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060646704
FEIN
Enumeration date
06/15/2016
Last updated
06/15/2016
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