Individual
COREY A CHAMPEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
263 FARMINGTON AVE, NEONATOLOGY, FARMINGTON, CT 06030-2948
(860) 679-3105
(860) 679-1403
Mailing address
65 KANE ST, PROVIDER ENROLLMENT - ELLIE ATKINS, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001691
CT
Other
Enumeration date
05/12/2006
Last updated
04/20/2010
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