Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4768 | CT |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4798 | CT |
NPI | 1003199217 |
---|---|
Provider Name | Katherine Bajda |
First Address | Stratford, CT 06615 |
Second Address | Stratford, CT 06615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2011 |
Last Update Date | 23/09/2011 |