Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 001278 | CT |
NPI | 1053459438 |
---|---|
Provider Name | Cynthia W. Walsh |
First Address | Willimantic, CT 06226-1142 |
Second Address | New Haven, CT 06511-2348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |