Healthcare Provider Details

I. General information

NPI: 1750669222
Provider Name (Legal Business Name): MARGARET H LENNON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2011
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 HIGH RIDGE RD
STAMFORD CT
06905-3018
US

IV. Provider business mailing address

20 BRIDGE ST
GREENWICH CT
06830-5238
US

V. Phone/Fax

Practice location:
  • Phone: 203-629-2822
  • Fax:
Mailing address:
  • Phone: 203-629-2822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR39973
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code364SS0200X
TaxonomySchool Clinical Nurse Specialist
License Number001863
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: