Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 62415 | CT |
NPI | 1063778082 |
---|---|
Provider Name | Dr. Laurel Karian Chandler |
First Address | Ridgefield, CT 06877-5610 |
Second Address | Darien, CT 06820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 18/09/2019 |