Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 15702 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 8794 | CT |
NPI | 1093798860 |
---|---|
Provider Name | Ms. Stefanie Anne Generao |
First Address | New Haven, CT 06511-6624 |
Second Address | New Haven, CT 06511-6624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2005 |
Last Update Date | 06/10/2020 |