Provider Demographics
NPI:1679306286
Name:NUTERANGELO, SOPHIA MARIE (RN)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE
Last Name:NUTERANGELO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-5020
Mailing Address - Country:US
Mailing Address - Phone:203-645-8901
Mailing Address - Fax:
Practice Address - Street 1:794 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-5020
Practice Address - Country:US
Practice Address - Phone:203-645-8901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10007028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse