Basic Information
| Provider Information | |||||||||
| NPI: | 1386066470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRIMIA | ||||||||
| FirstName: | AMBER | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 HALL BLVD | ||||||||
| Address2: | 3RD FLOOR, POD D | ||||||||
| City: | BLOOMFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060022918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607142338 | ||||||||
| FaxNumber: | 8607148612 | ||||||||
| Practice Location | |||||||||
| Address1: | 675 TOWER AVE STE 301 | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607142750 | ||||||||
| FaxNumber: | 8607148591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2014 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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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 | 005602 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LP0808X | 5602 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.