Doctor Name: | MRS. MELISSA CATHERINE RUSATE |
NPI Number: | 1427301753 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 5172 |
Business Practice Address: | 100 Grand St Provider Enrollment New Britain, CT - 060522016 |
Business Phone Number: | 8602245501 |
Business Fax Number: | |
Mailing Address: | 100 Grand St, Provider Enrollment NEW BRITAIN |
State: | CT |
Postal Code: | 060522016 |
Phone Number: | 8602245501 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2012 |
NPI Last Update Date: | 12/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 5172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |