Provider Demographics
NPI:1194276386
Name:PPML INC.
Entity type:Organization
Organization Name:PPML INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/APRN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CIPRIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:860-880-2525
Mailing Address - Street 1:130 S MAIN ST STE 1C
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1741
Mailing Address - Country:US
Mailing Address - Phone:860-880-2525
Mailing Address - Fax:860-880-8253
Practice Address - Street 1:130 S MAIN ST STE 1C
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1741
Practice Address - Country:US
Practice Address - Phone:860-880-2525
Practice Address - Fax:860-880-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-22
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008037060Medicaid