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General NPI Number Information
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NPI Number | 1821656190
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Entity Type | Individual
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Provider Name | DEANNA NARDELLA MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 150 SARGENT DR
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City | NEW HAVEN
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State | CT
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Zip | 06511-6100
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Country | US
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Telephone | 203-777-7411
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Fax |
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Provider Business Mailing Address
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Address Line | 789 HOWARD AVE BLDG BASEMENT
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City | NEW HAVEN
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State | CT
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Zip | 06519-1304
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Country | US
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Telephone | 203-688-2475
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Fax | 203-785-3932
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MT217806
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 70169
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License Number State | CT
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