Healthcare Provider Details

I. General information

NPI: 1144418955
Provider Name (Legal Business Name): THERESA A CUTILLO-SCHMITTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 EAST AVE SUITE V
NORWALK CT
06851-4903
US

IV. Provider business mailing address

2 WINTERGREEN CT
WOODBURY CT
06798-3218
US

V. Phone/Fax

Practice location:
  • Phone: 203-656-1452
  • Fax: 203-656-1485
Mailing address:
  • Phone: 203-263-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number002919
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: