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1184799413
DONNA MARIE TICE
WEST HAVEN, CT
NPI
1184799413
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Other Name
DONNA PETRILLO
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: CT 003511)
Enumeration Date
2006-11-21
Last Update Date
2007-07-08
Business Address
DONNA MARIE TICE APRN BC
950 CAMPBELL AVENUE VETERAN'S ADMINISTRATION MEDICAL CENTER
WEST HAVEN, CT 06516
Phone number: 203-932-5711
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Mailing Address
DONNA MARIE TICE APRN BC
10 REGENT DRIVE
SHELTON, CT 06484
Phone number: 203-925-7795
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