Individual
DIANA D'AMELIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
761 MAIN AVE, SUITE 200, NORWALK, CT 06851-1080
(203) 750-7400
(203) 846-9579
Mailing address
761 MAIN AVE, SUITE 200, NORWALK, CT 06851-1080
(203) 750-7400
(203) 846-9579
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001586
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001586
CT STATE LICENSE
CT
Enumeration date
11/07/2006
Last updated
01/01/2015
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