Individual
MARIA L ZANDONELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
17 PEPPERBUSH DR, CLINTON, CT 06413-1168
(860) 669-5302
Mailing address
17 PEPPERBUSH DR, CLINTON, CT 06413-1168
(860) 669-5302
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002961
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004241824
—
CT
01
—
2V6904
HEALTHNET
CT
01
—
400002961CT04
BLUE SHIELD
CT
Enumeration date
05/27/2005
Last updated
10/13/2008
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