Individual
MARY ELLEN COMOLLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CRNA
Contact information
Practice address
326 WASHINGTON ST, NORWICH, CT 06360-2740
(860) 889-8331
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
002971
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004243242
—
CT
Enumeration date
02/21/2007
Last updated
03/30/2015
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