Individual
MR. DANIEL CERVONKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS, CAS
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-9703
Mailing address
39 A P GATES RD, EAST HADDAM, CT 06423-1523
(860) 873-3512
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000159
CT
Other
Enumeration date
07/14/2006
Last updated
07/08/2007
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