Provider Demographics
NPI:1154553956
Name:GIONFRIDDO, MELISSA ANNE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANNE
Last Name:GIONFRIDDO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 BOSTON POST RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3476
Mailing Address - Country:US
Mailing Address - Phone:203-421-0444
Mailing Address - Fax:
Practice Address - Street 1:1291 BOSTON POST RD STE 200
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3476
Practice Address - Country:US
Practice Address - Phone:203-421-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily