Basic Information
Provider Information
NPI: 1033580071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARDONE
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 109 DORSET LN
Address2:  
City: MADISON
State: CT
PostalCode: 064431686
CountryCode: US
TelephoneNumber: 7328615197
FaxNumber:  
Practice Location
Address1: 20 YORK ST
Address2: NP-8
City: NEW HAVEN
State: CT
PostalCode: 065103220
CountryCode: US
TelephoneNumber: 2032006262
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2015
LastUpdateDate: 10/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X6336CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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