Individual
SUSAN VONTELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
538 LITCHFIELD ST, SUITE 201, TORRINGTON, CT 06790-6669
(860) 489-7017
(860) 489-8943
Mailing address
538 LITCHFIELD ST, SUITE 201, TORRINGTON, CT 06790-6669
(860) 489-7017
(860) 489-8943
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
001827
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004243333-00
BLUECARE FAMILY PLAN (MCD
CT
01
—
018270
CONNECTICARE
—
01
—
0220785
CIGNA
—
01
—
400001827CT01
ANTHEM BC/BS
CT
Enumeration date
01/13/2006
Last updated
07/08/2007
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