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General NPI Number Information
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NPI Number | 1689018582
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH PALDINO APRN
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Gender | Female
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 324 ELM ST STE 202B
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City | MONROE
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State | CT
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Zip | 06468-2284
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Country | US
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Telephone | 203-880-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 71 CINNAMON SPGS
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-3641
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Country | US
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Telephone | 860-573-7702
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 005327
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License Number State | CT
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