NPI 1790796647 · live from the CMS NPI Registry
Michael Corjulo, C.P.N.P.
Nurse Practitioner, Pediatrics in Hamden, CT. National Provider Identifier 1790796647, active.
NPI record
| NPI | 1790796647 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 299 Washington Ave Ste Ll, Hamden, CT 06518 |
| Practice phone | 203-288-4288 |
| Mailing address | 299 Washington Ave, Hamden, CT 06518 |
| Enumerated | August 10, 2006 |
| Last updated | May 3, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 002019 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.