Healthcare Provider Details

I. General information

NPI: 1205658911
Provider Name (Legal Business Name): MILUSKA VALERIA CIURLIZZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MOUNT PLEASANT RD
NEWTOWN CT
06470-1471
US

IV. Provider business mailing address

45 LAKEVIEW AVE
SHELTON CT
06484-2232
US

V. Phone/Fax

Practice location:
  • Phone: 203-426-1818
  • Fax:
Mailing address:
  • Phone: 203-898-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.014057
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: