Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 004407 | CT |
NPI | 1548577919 |
---|---|
Provider Name | Ms. Cynthia Veronica Mason |
First Address | Meriden, CT 06450 |
Second Address | Meriden, CT 06450-2378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 08/09/2010 |