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Individual

STEPHANIE MOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(239) 770-4448
Mailing address
180 WILLOW ST APT 2, NEW HAVEN, CT 06511-2572
(239) 770-4448

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
04/09/2020
Last updated
04/09/2020
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