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General NPI Number Information
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NPI Number | 1609300912
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Entity Type | Organization
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Legal Business Name | SUSAN N GRAMMATICO DNP FNP LLC
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 146 DANBURY RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-3427
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Country | US
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Telephone | 860-799-5900
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Fax | 860-799-5902
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Provider Business Mailing Address
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Address Line | 146 DANBURY RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-3427
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Country | US
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Telephone | 860-799-5900
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Fax | 860-799-5902
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | SUSAN GRAMMATICO
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Credential | DNP FNP
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Telephone | 860-799-5900
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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 | 002547
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License Number State | CT
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