Healthcare Provider Details

I. General information

NPI: 1720388341
Provider Name (Legal Business Name): ANN MARIE DILORETO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN MARIE DILORETO APRN

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RETREAT AVENUE HARTFORD HOSPITAL GERIATRIC PSYCHIATRY
HARTFORD CT
06106-3310
US

IV. Provider business mailing address

PO BOX 415933 HARTFORD HOSPITAL PROFESSIONAL SERVICES
BOSTON CT
02241-5933
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-7189
  • Fax:
Mailing address:
  • Phone: 860-545-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number000919
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: