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NPI 1942550991

NPI 1942550991 : ANTIGONA M AJRO APRN : TORRINGTON, CT

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General NPI Number Information
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    NPI Number           |    1942550991
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    Entity Type          |    Individual 
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    Provider Name        |    ANTIGONA M AJRO APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2012
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    Last Update Date     |    09/12/2013
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Provider Practice Location Address
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    Address Line         |    333 KENNEDY DR SUITE L201
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    City                 |    TORRINGTON
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    State                |    CT
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    Zip                  |    06790-3060
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    Country              |    US
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    Telephone            |    860-482-0261
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    Fax                  |    860-482-6301
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Provider Business Mailing Address
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    Address Line         |    333 KENNEDY DR SUITE L201
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    City                 |    TORRINGTON
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    State                |    CT
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    Zip                  |    06790-3060
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    Country              |    US
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    Telephone            |    860-482-0261
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    Fax                  |    860-482-6301
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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       |    005073
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    License Number State |    CT
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