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General NPI Number Information
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NPI Number | 1083446959
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Entity Type | Individual
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Provider Name | THERESA VALENTINO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 205 MAIN ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-3003
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Country | US
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Telephone | 203-466-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 60 CONCORD ST
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City | NEW HAVEN
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State | CT
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Zip | 06512-4005
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Country | US
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Telephone | 203-823-2903
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13749
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 121097
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License Number State | CT
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