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General NPI Number Information
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NPI Number | 1720357676
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Entity Type | Individual
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Provider Name | TERESA DRAKO MSN, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 44 ABBOTT TER
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City | WATERBURY
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State | CT
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Zip | 06702-1431
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Country | US
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Telephone | 203-755-4870
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Fax | 203-755-9016
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Provider Business Mailing Address
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Address Line | 541 EASTERN ST APT.1
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City | NEW HAVEN
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State | CT
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Zip | 06513-1709
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Country | US
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Telephone | 203-745-8483
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Fax | 203-507-2071
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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 | 004855
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License Number State | CT
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