| Doctor Name: | MAUREEN ELIZABETH FEARON |
| NPI Number: | 1043596646 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 004779 |
| Business Practice Address: | 6 Northwestern Dr Suite 303 Bloomfield, CT - 060023463 |
| Business Phone Number: | 8604434455 |
| Business Fax Number: | 8602868411 |
| Mailing Address: | 6 Northwestern Dr, Suite 303 BLOOMFIELD |
| State: | CT |
| Postal Code: | 060023463 |
| Phone Number: | 8604434455 |
| Fax Number: | 8602868411 |
| NPI Enumeration Date: | 10/26/2011 |
| NPI Last Update Date: | 02/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 004779 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |