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Individual

AILEEN MARIE DEAMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
44 WILLARD AVE, NEWINGTON, CT 06111
(860) 666-6951
Mailing address
25 BUENA VISTA RD, WEST HARTFORD, CT 06107-3203
(860) 561-5698

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
002169
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
40002169CT10
ANTHEM BCBS
Enumeration date
09/23/2005
Last updated
02/15/2008
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