Healthcare Provider Details

I. General information

NPI: 1518870872
Provider Name (Legal Business Name): CHRISTINA PREVOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 BOSTON POST RD
MILFORD CT
06460-2578
US

IV. Provider business mailing address

98 CUSTER ST
STAMFORD CT
06902-3155
US

V. Phone/Fax

Practice location:
  • Phone: 203-816-5179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11355
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: