Individual
KRISTEN DIPIETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
(860) 378-1160
Mailing address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
(860) 378-1160
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
001305
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222635676
TAX ID
CT
Enumeration date
11/11/2015
Last updated
11/11/2015
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