Healthcare Provider Details

I. General information

NPI: 1376334656
Provider Name (Legal Business Name): KRISTEN M CIOFFI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E MAIN ST
WATERBURY CT
06702-2310
US

IV. Provider business mailing address

141 E MAIN ST
WATERBURY CT
06702-2310
US

V. Phone/Fax

Practice location:
  • Phone: 203-574-9000
  • Fax:
Mailing address:
  • Phone: 203-574-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14613
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: