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Andrew Wormser
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NPI Number Detailed Information
Provider Information:
| Name: | Andrew Wormser |
| Gender: | M |
| Provider License Number If Given: | 1266238 |
NPI Information:
| NPI: | 1649279167 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 10/17/2011 |
Provider Business Mailing Address:
| Address: | 9 WASHINGTON AVE 2ND FLOOR Hamden, CT 06518 |
| Phone Number: | 2032483013 |
| Fax Number: | 2032482878 |
Provider Business Practice Location Address:
| Address: | 46 PRINCE ST New Haven, CT 06519 |
| Phone Number: | 2037720011 |
| Fax Number: | 2037859352 |
Provider Taxonomy:
| Primary: | 207R00000X |
| Secondary (if any): | |
| State: | CT |
