Individual provider · Type 1 NPI

Gina F. Lidestri, PA

Medical Physician Assistant · Bristol, CT

NPI number 1043403868 Active

Practice location

41 Brewster Rd
Bristol, CT 06010-5161

Specialties and licenses

Taxonomy	Code	License
Physician Assistant	363A00000X	001942 (CT)
Medical Physician Assistant Primary	363AM0700X	001942 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1043403868

Gina F. Lidestri, PA's National Provider Identifier is 1043403868, issued on Aug 24, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Bristol, CT. The record was last updated on Jan 21, 2012.