Sundstrom, Laura

Sundstrom, Laura is an individual health care provider with primary practice located at 374 Grand Ave Fair Haven Community Health Center, New Haven CT 06513. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Sundstrom, Laura can be contacted via phone (203) 777-7411.

Contact Information

Primary practice address
374 Grand Ave Fair Haven Community Health Center New Haven CT 06513
Phone: (203) 777-7411
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 000279 Connecticut

Profile Details

NPI number 1720056963
LBN Legal business name Sundstrom, Laura
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Feb 11th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720056963 NPPES
Connecticut MEDICAID 004235900

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