Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 19505 | CT |
NPI | 1447879846 |
---|---|
Provider Name | Karen Maria Gaudio |
First Address | Branford, CT 06405-5509 |
Second Address | Branford, CT 06405-5509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2020 |
Last Update Date | 15/04/2020 |