Individual
MISS MARY ELIZABETH SCHUSTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
67 MASONIC AVE, SUITE 3100, WALLINGFORD, CT 06492-3095
(203) 284-3144
(203) 284-3140
Mailing address
67 MASONIC AVE, SUITE 3100, WALLINGFORD, CT 06492-3095
(203) 284-3144
(203) 284-3140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2742
SC
363LF0000X
Family Nurse Practitioner
Primary
006357
CT
363LF0000X
Family Nurse Practitioner
APN2742
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0948
—
SC
01
—
Q42721179
CHAMPUS
—
Enumeration date
08/08/2006
Last updated
08/18/2016
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