Healthcare Provider Details

I. General information

NPI: 1134037690
Provider Name (Legal Business Name): RIANN DUFFY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WOODBURY RD
WATERTOWN CT
06795-2100
US

IV. Provider business mailing address

110 WOODBURY RD
WATERTOWN CT
06795-2100
US

V. Phone/Fax

Practice location:
  • Phone: 860-945-7762
  • Fax: 860-945-7766
Mailing address:
  • Phone: 860-945-7762
  • Fax: 860-945-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number18211
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: