Healthcare Provider Details

I. General information

NPI: 1427140243
Provider Name (Legal Business Name): BARBARA ELLEN PELUSE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VACT HEALTHCARE SYSTEM 950 CAMPBELL AVE
WEST HAVEN CT
06516
US

IV. Provider business mailing address

35 TUTTLE AVE
HAMDEN CT
06518-1513
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-5711
  • Fax:
Mailing address:
  • Phone: 203-287-8448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberE41050
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: