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NPI Code Detail

MEDICARE: JOAN M GILDEA MA

MEDICARE: JOAN M GILDEA MA
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
1363LP0200XPediatric Nurse Practitioner001946CT

General Provider Information

NPI Number : 1750356689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN M GILDEA MA
Provider Business Mailing Address
First Line : 126 MORGAN ST
Second Line :
City : STAMFORD
State : CT
Zip : 06905-5431
Country : US
Telephone Number : 203-327-1055
Fax Number :
Provider Business Practice Location Address
First Line : 126 MORGAN ST
Second Line :
City : STAMFORD
State : CT
Zip : 06905-5431
Country : US
Telephone Number : 203-327-1055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 07/08/2007

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Directions to “ JOAN M GILDEA MA” Practice Location

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