KEITH LAWRENCE ELLIS

BRIDGEPORT, CT
NPI1144654666
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: CT  5501)
Enumeration Date2013-09-03
Last Update Date2022-09-12
Business Address
KEITH LAWRENCE ELLIS
46 ALBION ST
BRIDGEPORT, CT 06605-2602
Phone number: 203-330-6000
Mailing Address
KEITH LAWRENCE ELLIS
46 ALBION ST
BRIDGEPORT, CT 06605-2602
Phone number: 203-330-6000