Healthcare Provider Details

I. General information

NPI: 1205177672
Provider Name (Legal Business Name): LYNN ELIZABETH MASTRIANNI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

247 FLANDERS ST
SOUTHINGTON CT
06489-2085
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-4822
  • Fax: 203-200-2099
Mailing address:
  • Phone: 860-919-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number006560
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number6560
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: