Healthcare Provider Details

I. General information

NPI: 1982429833
Provider Name (Legal Business Name): LAURA GUARDIANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 STRAITS TPKE LOWR LEVEL
MIDDLEBURY CT
06762-1835
US

IV. Provider business mailing address

1579 STRAITS TPKE LOWR LEVEL
MIDDLEBURY CT
06762-1835
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-7246
  • Fax: 203-598-0200
Mailing address:
  • Phone: 203-598-7246
  • Fax: 203-598-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14163
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: