Doctor Name: | BETH ANDERSEN |
NPI Number: | 1003839291 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 010302 |
Business Practice Address: | 67 Sand Pit Rd Suite 308 Danbury, CT - 068104032 |
Business Phone Number: | 2037437246 |
Business Fax Number: | 2037923920 |
Mailing Address: | 67 Sand Pit Rd, Suite 308 DANBURY |
State: | CT |
Postal Code: | 068104032 |
Phone Number: | 2037437246 |
Fax Number: | 2037923920 |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 12/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 010302 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |