Individual
SOOHYUN NAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 BUXTON FARM RD, STAMFORD, CT 06905
(203) 322-3221
Mailing address
30 BUXTON FARM RD, STAMFORD, CT 06905-1224
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
005075
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
005075
CT
Other
Enumeration date
12/22/2006
Last updated
12/02/2015
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