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1376507301
DIANE LOUISE FOUNTAS
WATERBURY, CT
NPI
1376507301
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2080A0000X Pediatrics, Adolescent Medicine
(Licence: CT 024436)
Enumeration Date
2006-04-14
Last Update Date
2007-07-09
Business Address
Dr. DIANE LOUISE FOUNTAS M.D.
1389 W MAIN ST SUITE 325
WATERBURY, CT 06708-3104
Phone number: 203-753-6776
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Mailing Address
Dr. DIANE LOUISE FOUNTAS M.D.
1389 W MAIN ST SUITE 325
WATERBURY, CT 06708-3104
Phone number: 203-753-6776
Copy
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