Individual
LAUREN YVONNE MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606
(203) 576-5877
Mailing address
93 BLUEBERRY HILL RESERVE, KILLINGWORTH, CT 06419-2330
(860) 304-5003
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4092
CT
363A00000X
Physician Assistant
PA6456
MA
Other
Enumeration date
02/21/2018
Last updated
06/18/2018
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