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General NPI Number Information
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NPI Number | 1265491245
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Entity Type | Individual
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Provider Name | MARIA IENI MD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 173 EAST AVE
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City | NEW CANAAN
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State | CT
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Zip | 06840-5614
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Country | US
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Telephone | 203-972-4250
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Fax | 203-801-2126
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Provider Business Mailing Address
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Address Line | 173 EAST AVE
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City | NEW CANAAN
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State | CT
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Zip | 06840-5614
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Country | US
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Telephone | 203-972-4250
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Fax | 203-801-2126
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 224210
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 55760
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License Number State | CT
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