Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 001096 | CT |
NPI | 1023162369 |
---|---|
Provider Name | Ms. Susan Frances Piscatelli |
First Address | Guilford, CT 06437-2960 |
Second Address | Guilford, CT 06437-2960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 10/03/2011 |