Provider Demographics
NPI:1477165041
Name:ARTEAGA-BLASIO, ANGELICA M (NP)
Entity Type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:M
Last Name:ARTEAGA-BLASIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:STE 41052
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2777
Mailing Address - Country:US
Mailing Address - Phone:203-296-2016
Mailing Address - Fax:203-923-1010
Practice Address - Street 1:32 STRAWBERRY HILL CT STE 3
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-327-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9081363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner