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General NPI Number Information
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NPI Number | 1295907491
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Entity Type | Organization
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Legal Business Name | GLORIA ANNITTO OLGAS LINGERIE
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2852 MAIN STREET
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone | 860-633-7241
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Fax |
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Provider Business Mailing Address
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Address Line | 2852 MAIN STREET
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | GLORIA ANNITTO
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Credential |
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Telephone | 860-633-7241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | CT
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