Provider Demographics
NPI:1962492439
Name:SEPOT, CLAUDIA V (APRN)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:V
Last Name:SEPOT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3607
Mailing Address - Country:US
Mailing Address - Phone:203-483-8300
Mailing Address - Fax:203-483-8314
Practice Address - Street 1:11 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3607
Practice Address - Country:US
Practice Address - Phone:203-483-8300
Practice Address - Fax:203-483-8314
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002789363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004229101Medicaid
CT004229101Medicaid
CT500001008Medicare ID - Type Unspecified