Provider Demographics
NPI:1720357676
Name:DRAKO, TERESA (MSN, APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DRAKO
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 EASTERN ST
Mailing Address - Street 2:APT.1
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-1709
Mailing Address - Country:US
Mailing Address - Phone:203-745-8483
Mailing Address - Fax:203-507-2071
Practice Address - Street 1:44 ABBOTT TER
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1431
Practice Address - Country:US
Practice Address - Phone:203-755-4870
Practice Address - Fax:203-755-9016
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily