Individual
STACY ANN DATRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4608
(203) 863-3553
Mailing address
110 COLONY RD, SEYMOUR, CT 06483-3252
(203) 732-2706
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
E54875
CT
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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