Individual
MR. ANANIAS GLORIA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
101 CENTERPOINT DR STE 215, MIDDLETOWN, CT 06457-7568
(888) 964-6681
(888) 662-0859
Mailing address
41 GRIEB TRL, WALLINGFORD, CT 06492-2655
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
12.012499
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
12.012499
CT
Other
Enumeration date
10/11/2023
Last updated
03/11/2024
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