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1316003908
SAMUEL W. GASTON
FARMINGTON, CT
NPI
1316003908
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CT 000828)
Enumeration Date
2006-12-28
Last Update Date
2022-09-20
Business Address
-- SAMUEL W. GASTON PA
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2290
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Mailing Address
-- SAMUEL W. GASTON PA
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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