Provider Demographics
NPI:1811191554
Name:GREENE, CONSTANCE ANN CASTELLI (RN MS CDE RD CDN CMH)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ANN CASTELLI
Last Name:GREENE
Suffix:
Gender:F
Credentials:RN MS CDE RD CDN CMH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:284 QUARRY ROAD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-414-7612
Mailing Address - Fax:203-877-5918
Practice Address - Street 1:284 QUARRY ROAD
Practice Address - Street 2:SUITE 7
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-414-7612
Practice Address - Fax:203-877-5918
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00245 CD N133N00000X
CT000245 RD133V00000X
CTE31188 RN MS163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTOV6321OtherHEALTHNET
CTP2593836OtherOXFORD
CT270000245CT01OtherANTHEM