Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 67051 | CT |
NPI | 1114218583 |
---|---|
Provider Name | Stephanie Marie Eosten Joyce |
First Address | New London, CT 06320-4769 |
Second Address | New London, CT 06320-4769 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 09/12/2020 |