MEDICARE: MUGUETTE C ARENAS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	12.013720	CT

General Provider Information

NPI Number	:	1740012665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUGUETTE C ARENAS APRN

Provider Business Mailing Address
First Line	:	401 SHIPPAN AVE # 201
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-6075
Country	:	US
Telephone Number	:
Fax Number	:	203-406-4462

Provider Business Practice Location Address
First Line	:	401 SHIPPAN AVE STE 201
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-6075
Country	:	US
Telephone Number	:	203-658-9507
Fax Number	:	203-406-4462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/19/2024

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