Provider Demographics
NPI:1902893274
Name:COMFREY, PAULINE (APRN)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:
Last Name:COMFREY
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 1:15 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1351
Mailing Address - Country:US
Mailing Address - Phone:203-452-8322
Mailing Address - Fax:203-452-8326
Practice Address - Street 1:4 CORPORATE DR
Practice Address - Street 2:SUITE 290
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6211
Practice Address - Country:US
Practice Address - Phone:203-452-8322
Practice Address - Fax:203-944-2028
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001352363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics