NPI 1053952283

Samara Dejesus

Practitioner Licensed Practical Nurse Stratford, CT

Practice location

Address: 419 Bruce Ave, Stratford, CT 06615-5525
Phone: (203) 923-4211

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 40813 (CT)

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Registry record

NPI: 1053952283
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Sep 2019
Record last updated: 29 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.