Individual
SUSAN DAGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
40 HART ST, NEW BRITAIN, CT 06052-1743
(860) 229-0100
(860) 225-2647
Mailing address
40 HART ST, NEW BRITAIN, CT 06052-1743
(860) 229-0100
(860) 225-2647
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
E50759
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194100
CONNECTICARE
CT
01
—
400001941CT01
BLUE CROSS
CT
01
—
500008445
RAILROAD MEDICARE
CT
Enumeration date
06/29/2006
Last updated
05/07/2009
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