Organization
PEDIATRIC ADVANCED CARE OF WEST HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH J MARCUCIO APRN (OWNER)
(203) 889-2297
Entity
Organization
Contact information
Practice address
755 CAMPBELL AVE, SUITE 2, WEST HAVEN, CT 06516-3715
(203) 889-2297
Mailing address
24 N COE LN, ANSONIA, CT 06401-2818
(203) 732-1662
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
004531
CT
Other
Enumeration date
02/18/2016
Last updated
04/05/2016
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