Individual
MISS DIANE H PUPPOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
883 PADDOCK AVE, MERIDEN, CT 06450-7044
(203) 630-5314
Mailing address
883 PADDOCK AVE, MERIDEN, CT 06450-7044
(203) 630-5314
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
000847
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890000489
MED ID TYPE UNSPECIFIED
CT
Enumeration date
04/13/2007
Last updated
03/02/2016
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