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General NPI Number Information
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NPI Number | 1639286362
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Entity Type | Individual
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Provider Name | CARMEN IRIS IPPOLITO CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 1423 CHAPEL ST RAPHAEL HOSPITAL ANESTHESIA ASSOCIATES
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City | NEW HAVEN
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State | CT
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Zip | 06511
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Country | US
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Telephone | 203-789-3538
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Fax | 203-865-2983
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Provider Business Mailing Address
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Address Line | 15 WOODMERE CIRCLE
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City | NORTH HAVEN
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State | CT
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Zip | 06473
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Country | US
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Telephone | 203-248-6009
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN000133
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNE35834
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License Number State | CT
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