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Carly Melissa Madore, APRN
Family Nurse Practitioner in Niantic, Connecticut
NPI 1396012498

Carly Melissa Madore is a Family Nurse Practitioner based in Haddam, CT and is specialized in Family. Carly Melissa Madore practices in Niantic, CT and has the professional credentials of APRN. The NPI Number for Carly Melissa Madore is 1396012498 and holds a License No. 4830 (Connecticut).

The current practice location address for Carly Melissa Madore is 248 Flanders Rd, Niantic, CT and can be reached out via phone at 860-739-5426.

Location: 248 Flanders Rd, Niantic, CT, 06438-1259
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396012498
Provider Name
Carly Melissa Madore
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
248 Flanders Rd, Niantic, CT, 06438-1259
Phone Number
860-739-5426
Fax Number
Provider Enumeration Date
11/18/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
D400170759 01 CT MEDICARE- NGS
1396012498 05 CT
institution
Provider Business Practice Location Address Details
Address
248 Flanders Rd
City
Niantic
State
Connecticut
Zip
06357-1264
Phone Number
860-739-5426
Fax Number
person
Provider Business Mailing Address Details
Address
248 Flanders Rd
City
Niantic
State
Connecticut
Zip
06357-1264
Phone Number
860-739-5426
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
004830 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
4830 (Connecticut)
Definition
Definition to come...
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