Individual
LORI J. CRETELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 DEVINE ST, NORTH HAVEN, CT 06473-2195
(203) 789-6047
Mailing address
226 MILL HILL AVE, 3RD FLOOR, BRIDGEPORT, CT 06610-2826
(203) 789-6047
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
039546
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001395468
—
CT
01
—
010039546CT03
ANTHEM BLUE CROSS AND BLU
CT
Enumeration date
04/27/2006
Last updated
12/04/2015
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