Individual
NANCY SANTANIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 GRAND ST, MEDICAL STAFF OFFICE, NEW BRITAIN, CT 06052-2016
(860) 224-5305
(860) 224-5565
Mailing address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5305
(860) 224-5565
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000341
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000341
LIC
CT
Enumeration date
04/09/2007
Last updated
07/08/2007
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