ELISE MARIAM SAGE

EAST HARTFORD, CT
NPI1598048878
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0200X Nurse Practitioner Pediatrics
(Licence: CT  12.005079)
Additional Taxonomies363LP0200X Nurse Practitioner Pediatrics
(Licence: MA  2268080)
163W00000X Registered Nurse
(Licence: CT  10.107616)
363LP0200X Nurse Practitioner Pediatrics
(Licence: CT  005079)
Enumeration Date2011-09-23
Last Update Date2015-07-30
Business Address
ELISE MARIAM SAGE PNP
869 FORBES ST
EAST HARTFORD, CT 06118-1958
Phone number: 860-622-5343
Mailing Address
ELISE MARIAM SAGE PNP
80 PHOENIX AVE 201
WATERBURY, CT 06702-1418
Phone number: 203-756-8021