Individual
MARY LIZABETH AQUAVIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
690 MAIN ST S STE 1, SOUTHBURY, CT 06488-2387
(203) 262-4600
Mailing address
385 MAIN ST S, SOUTHBURY, CT 06488-4240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025685
CT
Other
Enumeration date
10/06/2006
Last updated
07/31/2019
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