GINA F LIDESTRI

BRISTOL, CT
NPI1043403868
Former NameGINA F MANGARI
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: CT  001942)
Additional Taxonomies363A00000X Physician Assistant
(Licence: CT  001942)
Enumeration Date2007-08-24
Last Update Date2012-01-21
Business Address
-- GINA F LIDESTRI PA
41 BREWSTER RD
BRISTOL, CT 06010-5161
Phone number: 860-585-3313
Mailing Address
-- GINA F LIDESTRI PA
41 BREWSTER RD
BRISTOL, CT 06010-5161
Phone number: 860-585-3313