Healthcare Provider Details

I. General information

NPI: 1255254314
Provider Name (Legal Business Name): MONICA ANNMARIE CRESTA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

200 BLAKESLEE ST APT 64
BRISTOL CT
06010-6399
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-6178
  • Fax: 860-714-1501
Mailing address:
  • Phone: 860-714-6178
  • Fax: 860-714-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number180137
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: