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General NPI Number Information
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NPI Number | 1245368513
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Entity Type | Individual
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Provider Name | MARY SUSAN HUNGERFORD A.P.R.N.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 305 BOSTON AVE
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City | STRATFORD
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State | CT
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Zip | 06614-5246
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Country | US
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Telephone | 203-384-3377
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06615-6556
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Country | US
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Telephone | 203-556-5223
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | E42847
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License Number State | CT
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