| Professional Nurse Practitioner | |
|
127 Hampton Ct Newington CT 06111-1144 | |
| (860) 983-9965 | |
| Not Available |
| Full Name | Professional Nurse Practitioner |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 127 Hampton Ct, Newington, Connecticut |
| Authorized Official Name and Position | Marisol Rodriguez (OWNER) |
| Authorized Official Contact | 4753026667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Nurse Practitioner 127 Hampton Ct Newington CT 06111-1144 Ph: (860) 983-9965 | Professional Nurse Practitioner 127 Hampton Ct Newington CT 06111-1144 Ph: (860) 983-9965 |
| NPI Number | 1710605845 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710605845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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