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General NPI Number Information
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NPI Number | 1871919399
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Entity Type | Organization
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Legal Business Name | RUPOLO ENTERPIRSES LLC
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 03/07/2014
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Provider Practice Location Address
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Address Line | 259 MAIN ST SUITE 4
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City | STAMFORD
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State | CT
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Zip | 06901-2927
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Country | US
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Telephone | 203-705-0220
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Fax | 203-705-0221
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Provider Business Mailing Address
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Address Line | 65 HIGH RIDGE RD # 474
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City | STAMFORD
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State | CT
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Zip | 06905-3800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NICOL PATRICIA RUPOLO
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Credential |
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Telephone | 203-705-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCA #856
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License Number State | CT
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