Individual
VIKTORIYA ANATOLIEVNA STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
35 DANFORTH LN, WEST HARTFORD, CT 06110-2436
(860) 987-7341
Mailing address
35 DANFORTH LN, WEST HARTFORD, CT 06110-2436
(860) 987-7341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7850
CT
363LF0000X
Family Nurse Practitioner
Primary
7850
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
7850
CT
Other
Enumeration date
09/10/2018
Last updated
10/31/2018
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