Healthcare Provider Details

I. General information

NPI: 1336067495
Provider Name (Legal Business Name): STELLA BRAGONI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 LEDGEBROOK DR
MANSFIELD CENTER CT
06250-1664
US

IV. Provider business mailing address

49 OLD COUNTY RD
HIGGANUM CT
06441-4447
US

V. Phone/Fax

Practice location:
  • Phone: 860-455-1404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number844
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: