Individual
SHINU KURIAKOSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
226 MILL HILL AVE, 3RD FLOOR, BRIDGEPORT, CT 06610-2811
(203) 384-3873
(203) 384-3829
Mailing address
PO BOX 5246, BRIDGEPORT, CT 06610-0246
(203) 384-3873
(203) 384-3829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001130
CT
Other
Enumeration date
03/17/2006
Last updated
07/08/2007
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