Provider Demographics
NPI:1497719926
Name:MCKENNA-SEMAN, VIRGINIA FOSSATY (DC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:FOSSATY
Last Name:MCKENNA-SEMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-1819
Mailing Address - Country:US
Mailing Address - Phone:203-597-8303
Mailing Address - Fax:203-597-8315
Practice Address - Street 1:1869 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-1819
Practice Address - Country:US
Practice Address - Phone:203-597-8303
Practice Address - Fax:203-597-8315
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000767CT03OtherANTHEM (WTB Y)
CT0000215078001OtherUNITED HEALTHCARE
CT050000767CT02OtherANTHEM (NEWTOWN)
CT767OtherHEALTHNET
CTP2751494OtherOXFORD HEALTHPLANS
CT050000767CT03OtherANTHEM (WTB Y)