Basic Information
Provider Information | |||||||||
NPI: | 1184821555 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | DENICOLA | ||||||||
FirstName: | ALLISON | ||||||||
MiddleName: | ROSE | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | APRN, BC | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | AMOROSI | ||||||||
OtherFirstName: | ALLISON | ||||||||
OtherMiddleName: | ROSE | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 35 KATRINA CIR | ||||||||
Address2: |   | ||||||||
City: | BETHEL | ||||||||
State: | CT | ||||||||
PostalCode: | 068013310 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2037431437 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 67 SANDPIT ROAD | ||||||||
Address2: | SUITE 308 | ||||||||
City: | DANBURY | ||||||||
State: | CT | ||||||||
PostalCode: | 068104032 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2037437246 | ||||||||
FaxNumber: | 2037923920 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/29/2007 | ||||||||
LastUpdateDate: | 07/20/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 003636 | CT | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.