Provider Demographics
NPI:1588846844
Name:MIGLIARO, ERIN MICHELLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MICHELLE
Last Name:MIGLIARO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:MICHELLE
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1 BRADLEY RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2285
Mailing Address - Country:US
Mailing Address - Phone:203-389-2278
Mailing Address - Fax:203-389-2643
Practice Address - Street 1:1 BRADLEY RD
Practice Address - Street 2:SUITE 502
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2285
Practice Address - Country:US
Practice Address - Phone:203-389-2278
Practice Address - Fax:203-389-2643
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11893256OtherCAQH