Provider Demographics
NPI:1386953339
Name:PISANI, CAROL J (APRN)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:PISANI
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 1:935 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4547
Mailing Address - Country:US
Mailing Address - Phone:203-522-6088
Mailing Address - Fax:
Practice Address - Street 1:935 WHITE PLAINS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1742
Practice Address - Country:US
Practice Address - Phone:203-522-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004491363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health