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NPI 1508902933

NPI 1508902933 : CHRISTINE ANN DIRIENZO MS CCC-A : WINDSOR, CT

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General NPI Number Information
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    NPI Number           |    1508902933
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINE ANN DIRIENZO MS CCC-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/30/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    340 BROAD ST 
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    City                 |    WINDSOR
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    State                |    CT
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    Zip                  |    06095-3030
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    Country              |    US
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    Telephone            |    860-688-8887
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    Fax                  |    860-687-1744
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Provider Business Mailing Address
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    Address Line         |    24 INDIAN TRAIL 
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    City                 |    SOUTH WINDSOR
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    State                |    CT
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    Zip                  |    06074
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    Country              |    US
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    Telephone            |    860-432-1295
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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        |    237600000X
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    Taxonomy Name        |    Audiologist-Hearing Aid Fitter
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    License Number       |    000457
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    License Number State |    CT
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