Organization
NUTMEG PEDIATRIC PULMONARY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINA M PALAZZO M.D. (OWNER)
(203) 208-2395
Entity
Organization
Contact information
Practice address
6 BUSINESS PARK DR, SUITE 202, BRANFORD, CT 06405-2988
(203) 208-2395
(203) 433-4638
Mailing address
6 BUSINESS PARK DR, SUITE 202, BRANFORD, CT 06405-2988
(203) 208-2395
(203) 433-4638
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
034923
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034923
LICENSE
CT
Enumeration date
11/21/2012
Last updated
12/11/2012
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