Provider Demographics
NPI:1093780256
Name:MARINONE, SHERYL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:
Last Name:MARINONE
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 1:29 MARION ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR LOCKS
Mailing Address - State:CT
Mailing Address - Zip Code:06096-2703
Mailing Address - Country:US
Mailing Address - Phone:860-623-6649
Mailing Address - Fax:
Practice Address - Street 1:3A PASCO DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-1700
Practice Address - Country:US
Practice Address - Phone:860-623-4100
Practice Address - Fax:860-623-4101
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS67049Medicare UPIN