Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KRISTA DEROSA
Active Sole ProprietorKRISTA DEROSA is a 163WM1400X healthcare provider located in MIDDLEBURY, Connecticut. NPI 1245696798 is currently active in the NPPES registry. Verify at CMS.
163WM1400X · MIDDLEBURY, CT
Registration Details
- NPI Number
- 1245696798
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 13, 2016 (10.625383324383 yrs)
- Last Updated
- Jan 13, 2016
- Licenses
-
128313 (CT)006291 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
590 MIDDLEBURY RDMIDDLEBURY, CT, 067622562Browse CT providers · Browse ZIP 06762
- Phone
- 8608667115
- Primary Specialty
-
163WM1400X
163WM1400X
- Additional Specialty
- 163WM1400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.