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1962928283
EVA ALICJA WALLACE
BRIDGEPORT, CT
NPI
1962928283
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CT 7128)
Enumeration Date
2017-08-17
Last Update Date
2017-08-17
Business Address
Dr. EVA ALICJA WALLACE DNP
267 GRANT ST
BRIDGEPORT, CT 06610-2805
Phone number: 203-384-3000
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Mailing Address
Dr. EVA ALICJA WALLACE DNP
152 KNEEN ST
SHELTON, CT 06484-3935
Phone number:
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