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Individual

DONNA L MARIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
67 MASONIC AVE, SUITE 3100, WALLINGFORD, CT 06492-3095
(203) 284-3144
(203) 284-3150
Mailing address
67 MASONIC AVE, SUITE 3100, WALLINGFORD, CT 06492-3095
(203) 626-6511
(203) 284-3150

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
002774
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
002774
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004231023
CT
Enumeration date
07/26/2006
Last updated
07/31/2013
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