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General NPI Number Information
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NPI Number | 1821303868
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Entity Type | Individual
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Provider Name | MS. SEQUESE LACOLE ARLINE
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Gender | Female
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Dates
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Enumeration Date | 08/14/2010
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Last Update Date | 08/14/2010
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Provider Practice Location Address
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Address Line | 15 WALKER LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2853
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Country | US
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Telephone | 860-719-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 442 BARBOUR ST 2A
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City | HARTFORD
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State | CT
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Zip | 06120-1047
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Country | US
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Telephone | 860-719-7774
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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