Provider Demographics
NPI:1467287227
Name:ATEHORTUA GODOY, CLAUDIA MARCELA
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:MARCELA
Last Name:ATEHORTUA GODOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FAIRFIELD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4252
Mailing Address - Country:US
Mailing Address - Phone:203-394-6529
Mailing Address - Fax:
Practice Address - Street 1:180 FAIRFIELD AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4252
Practice Address - Country:US
Practice Address - Phone:203-394-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program