Individual
MS. MARVA QUACCOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
130 BROADBRIDGE RD, BRIDGEPORT, CT 06610-1121
(203) 373-7559
Mailing address
130 BROADBRIDGE RD, BRIDGEPORT, CT 06620
(203) 373-7559
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
234908
CT
164X00000X
Licensed Vocational Nurse
Primary
234908
NY
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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