Individual
MICHAEL P SUPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 ASYLUM AVE, SUITE 4320, HARTFORD, CT 06105-1770
(860) 714-5237
(860) 714-8097
Mailing address
1000 ASYLUM AVE, SUITE 2109A, HARTFORD, CT 06105-1770
(860) 714-4658
(860) 714-8311
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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