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General NPI Number Information
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NPI Number | 1447898861
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Entity Type | Individual
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Provider Name | GUSTAVO DAVID HERRERA-BRITO
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Gender | Male
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 1952 WHITNEY AVE
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City | HAMDEN
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State | CT
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Zip | 06517-1209
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Country | US
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Telephone | 203-848-1803
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Fax | 203-848-1777
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Provider Business Mailing Address
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Address Line | 1952 WHITNEY AVE
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City | HAMDEN
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State | CT
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Zip | 06517-1209
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Country | US
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Telephone | 203-848-1803
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Fax | 203-848-1777
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 8659
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License Number State | CT
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