Individual
ANNETTE LUPINACCI HEADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
56 WHITEHALL AVENUE, MYSTIC, CT 06355
(860) 536-1354
(860) 536-7043
Mailing address
56 WHITEHALL AVENUE, MYSTIC, CT 06355
(860) 536-1354
(860) 536-7043
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
034245
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001342451
—
CT
Enumeration date
08/21/2006
Last updated
09/09/2010
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