Provider Demographics
NPI:1861709669
Name:FARIA, ANNA VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:VICTORIA
Last Name:FARIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98 HOWE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-7000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:968 FAIRFIELD AVE
Practice Address - Street 2:SOUTHWEST COMMUNITY HEALTH CENTER
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-1116
Practice Address - Country:US
Practice Address - Phone:203-579-8517
Practice Address - Fax:203-332-5600
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT4450363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics