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General NPI Number Information
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NPI Number | 1457175937
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Entity Type | Individual
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Provider Name | RUDO MUPOPERI-EXANTUS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 4 HAZEL AVE
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City | NAUGATUCK
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State | CT
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Zip | 06770-4706
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Country | US
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Telephone | 914-844-5513
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Fax |
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Provider Business Mailing Address
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Address Line | 24 ROCKWOOD LN
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City | MONROE
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State | CT
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Zip | 06468-1034
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Country | US
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Telephone | 914-844-5513
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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 | 13814
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License Number State | CT
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