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NPI Code Detail

MEDICARE: ROSEMARY FANALE APRN

MEDICARE: ROSEMARY FANALE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner001543CT

General Provider Information

NPI Number : 1588614465
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY FANALE APRN
Provider Business Mailing Address
First Line : 21 WATERVILLE RD
Second Line :
City : AVON
State : CT
Zip : 06001-2097
Country : US
Telephone Number : 860-674-2691
Fax Number : 860-677-6443
Provider Business Practice Location Address
First Line : 21 WATERVILLE RD
Second Line :
City : AVON
State : CT
Zip : 06001-2097
Country : US
Telephone Number : 860-674-2691
Fax Number : 860-677-6443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 10/20/2008

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Directions to “ ROSEMARY FANALE APRN” Practice Location

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