Individual
MS. MICHELLE L PUGLIARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, CANCER CENTER, FARMINGTON, CT 06030-2875
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
004485
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
004485
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376596826
—
CT
Enumeration date
06/08/2010
Last updated
05/01/2013
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