Nicholas Mudry, | |
282 Washington St, Hartford, CT 06106-3322 | |
(860) 545-9440 | |
Not Available |
Full Name | Nicholas Mudry |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 282 Washington St, Hartford, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326752684 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 143925 (Connecticut) | Secondary |
363LF0000X | Nurse Practitioner - Family | 12235 (Connecticut) | Primary |
Entity Name | Connecticut Children's Specialty Group, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669448882 PECOS PAC ID: 6002720117 Enrollment ID: O20031113000468 |
Mailing Address | Practice Location Address |
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Nicholas Mudry, 158 Broad St Apt H, Milford, CT 06460-4758 Ph: () - | Nicholas Mudry, 282 Washington St, Hartford, CT 06106-3322 Ph: (860) 545-9440 |
Caroline Clara Regan, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 185 Asylum St, Hartford, CT 06103 Phone: 860-215-2117 | |
Mrs. Brooke M P Chaves, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 Woodland St, Hartford, CT 06105 Phone: 860-714-4680 | |
Jocelyn Calabro, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 114 Woodland St, Hartford, CT 06105 Phone: 860-714-4000 | |
Michael Brian Banik, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 80 Seymour St, Hartford, CT 06106 Phone: 860-545-5000 | |
Deborah Mcgrath, APRN/FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Asylum Ave, Hartford, CT 06105 Phone: 860-714-4786 | |
Marlo Derla, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 114 Woodland St, Hartford, CT 06105 Phone: 860-714-0000 | |
Audrey Bakanauskas, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 Woodland St, Cardiology, Hartford, CT 06105 Phone: 860-714-4161 Fax: 860-714-8001 |