Basic Information
| Provider Information | |||||||||
| NPI: | 1366523144 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERRETTI | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 GRAND ST | ||||||||
| Address2: | |||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060522016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602245305 | ||||||||
| FaxNumber: | 8602245565 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 GRAND ST | ||||||||
| Address2: | MEDICAL STAFF OFFICE, ATT: ONDREA CHASSE | ||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060522016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602255305 | ||||||||
| FaxNumber: | 8602245565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 002308 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 002308 | 01 | CT | LIC | OTHER |