Active NPI
Pam Cucinelli, RN
- Registered Nurse
- Middletown, CT
National Provider Identifier
1972792018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 071410
- Practice address
- 635 Main St
Middletown, CT 06457-2718 - Phone
- (860) 347-6971
- Fax
- (860) 343-7379
- NPI assigned
- Oct 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 071410 | CT | Primary |
Addresses
Primary practice location
635 Main St
Middletown, CT 06457-2718
Mailing address
635 Main St
Attn: Credentialing Department
Middletown, CT 06457-2718
Phone (860) 347-6971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004236346 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071410 | CT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219104000000",
"number": "1972792018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 MAIN ST",
"address_2": "ATTN: CREDENTIALING DEPARTMENT",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572718",
"telephone_number": "860-347-6971",
"fax_number": "860-638-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 MAIN ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572718",
"telephone_number": "860-347-6971",
"fax_number": "860-343-7379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUCINELLI",
"first_name": "PAM",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-15",
"last_updated": "2008-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "071410",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004236346",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.