Healthcare Provider Details

I. General information

NPI: 1336894021
Provider Name (Legal Business Name): MARY ATTRIDGE-SILVESTRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 02/21/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 CHURCH ST STE 1921
NEW HAVEN CT
06510-2100
US

IV. Provider business mailing address

188 PUTNAM RD
CENTRAL VILLAGE CT
06332-3239
US

V. Phone/Fax

Practice location:
  • Phone: 475-655-3125
  • Fax:
Mailing address:
  • Phone: 860-377-7196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: