Individual
STEPHANIE BIRN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-4677
(203) 384-3135
Mailing address
20 YORK STREET, CB-329, NEW HAVEN, CT 06510-3220
(203) 688-1734
(203) 688-9638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000839
CT
363AM0700X
Medical Physician Assistant
Primary
000839
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000839
CT LICENSE
CT
Enumeration date
07/12/2006
Last updated
06/09/2020
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