Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 042429 | CT |
NPI | 1003919267 |
---|---|
Provider Name | Stefanie L Durstin |
First Address | Harwinton, CT 06791 |
Second Address | Torrington, CT 06790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |