Provider Demographics
NPI:1962771865
Name:NUNZIANTO, JOANNA
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:NUNZIANTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HORSE POND RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2513
Mailing Address - Country:US
Mailing Address - Phone:203-619-3747
Mailing Address - Fax:
Practice Address - Street 1:80 HORSE POND RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2513
Practice Address - Country:US
Practice Address - Phone:203-619-3747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00109781835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric