Healthcare Provider Details

I. General information

NPI: 1326961376
Provider Name (Legal Business Name): THELMA ANGRISANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAMPUS DR
ORANGE CT
06477-3646
US

IV. Provider business mailing address

260 CROWN ST APT 2L
NEW HAVEN CT
06511-6689
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6437
  • Fax:
Mailing address:
  • Phone: 646-387-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number236405
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: