Bourassa, Stefanie
Bourassa, Stefanie is an individual health care provider with primary practice located at 145 Hazard Ave Suite B, Enfield CT 06082-4521. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bourassa, Stefanie can be contacted via phone (860) 265-2571.Contact Information
Primary practice address
145 Hazard Ave Suite B
Enfield CT 06082-4521
Phone: (860) 265-2571
Fax: (860) 265-2574
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 008279 | Connecticut |
Profile Details
| NPI number | 1497925283 |
|---|---|
| LBN Legal business name | Bourassa, Stefanie |
| Credentials | MSPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2008 |
| Last updated | Mar 7th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497925283 | NPPES |
| Connecticut | Other | 51084 | BIRTHDATE |
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