Provider Demographics
NPI:1144418955
Name:CUTILLO-SCHMITTER, THERESA A (APRN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:CUTILLO-SCHMITTER
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 1:2 WINTERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3218
Mailing Address - Country:US
Mailing Address - Phone:203-263-2332
Mailing Address - Fax:
Practice Address - Street 1:71 EAST AVE
Practice Address - Street 2:SUITE V
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4903
Practice Address - Country:US
Practice Address - Phone:203-656-1452
Practice Address - Fax:203-656-1485
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002919364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1144418955Medicaid
CTD400002835Medicare PIN