Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 002754 | CT |
NPI | 1013045277 |
---|---|
Provider Name | Judith Karen Adelstein |
First Address | Bridgeport, CT 06610-2805 |
Second Address | Fairfield, CT 06824-6447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 28/02/2015 |