Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 77552 | CT |
NPI | 1023158904 |
---|---|
Provider Name | Kathryn A Mcvicar |
First Address | New Haven, CT 06510-3218 |
Second Address | New Haven, CT 06510-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 12/10/2016 |