Provider Demographics
NPI:1578273736
Name:MASTROPIETRO, SUSAN (CD(DONA), CLC, CBE)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MASTROPIETRO
Suffix:
Gender:F
Credentials:CD(DONA), CLC, CBE
Other - Prefix:
Other - First Name:SOOO-Z
Other - Middle Name:
Other - Last Name:MASTROPIETRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CD(DONA), CLC, CBE
Mailing Address - Street 1:41 SPICER RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4531
Mailing Address - Country:US
Mailing Address - Phone:203-536-0651
Mailing Address - Fax:
Practice Address - Street 1:41 SPICER RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4531
Practice Address - Country:US
Practice Address - Phone:203-536-0651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
CT374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula