Provider Demographics
NPI:1841642923
Name:MAGALHAES DE MELO MANARA MILETTO, FERNANDA (MD)
Entity type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:MAGALHAES DE MELO MANARA MILETTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SONGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-3442
Mailing Address - Country:US
Mailing Address - Phone:860-869-5275
Mailing Address - Fax:
Practice Address - Street 1:7 DUNNING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2005
Practice Address - Country:US
Practice Address - Phone:603-542-6700
Practice Address - Fax:603-542-6730
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine