Healthcare Provider Details

I. General information

NPI: 1467592527
Provider Name (Legal Business Name): BETTINA MAGLIATO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND ST HOSPITAL OF CENTRAL CONNECTICUT
NEW BRITAIN CT
06052-2016
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5900
  • Fax: 960-224-5816
Mailing address:
  • Phone: 860-224-5900
  • Fax: 960-224-5816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number6437
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: