Jacquelyne Phanavong
NPI #1730439597 in New Britain, Connecticut
Provider Information
- NPI Number
- 1730439597
- Entity Type
- Individual
- Name
- Jacquelyne Phanavong
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Sep 19, 2012
- Last Updated
- Feb 15, 2017
Practice Location
- Address
- 100 GRAND ST
- City
- New Britain
- State
- Connecticut
- ZIP Code
- 06052-2016
- Phone
- (860) 224-5675
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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