Healthcare Provider Details

I. General information

NPI: 1205460110
Provider Name (Legal Business Name): ANAICA QUAO DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL PLZ
STAMFORD CT
06902-3602
US

IV. Provider business mailing address

1145 N COLONY RD STE 3
WALLINGFORD CT
06492-1796
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-7777
  • Fax:
Mailing address:
  • Phone: 860-507-9883
  • Fax: 203-621-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8863
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: