Healthcare Provider Details

I. General information

NPI: 1689505117
Provider Name (Legal Business Name): CAMILLA MARZELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 WATER ST
TORRINGTON CT
06790-5339
US

IV. Provider business mailing address

67 EDGE RD
WATERTOWN CT
06795-2718
US

V. Phone/Fax

Practice location:
  • Phone: 203-558-3975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11260
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: