Provider Demographics
NPI:1922400712
Name:GRAMUGLIA, PATRICIA (APRN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GRAMUGLIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 GOULD DR
Mailing Address - Street 2:APT D
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-1161
Mailing Address - Country:US
Mailing Address - Phone:860-256-7866
Mailing Address - Fax:
Practice Address - Street 1:324 ELM ST
Practice Address - Street 2:SUITE 202B
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2280
Practice Address - Country:US
Practice Address - Phone:203-880-5335
Practice Address - Fax:203-907-1234
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner