Divenere, Debra M

Divenere, Debra M is an individual health care provider with primary practice located at 134 Grandview Ave Suite 208, Waterbury CT 06708-2507. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Divenere, Debra M can be contacted via phone (203) 755-3279.

Contact Information

Primary practice address
134 Grandview Ave Suite 208 Waterbury CT 06708-2507
Phone: (203) 755-3279
Fax: (203) 755-3057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 0002590 Connecticut

Profile Details

NPI number 1376559492
LBN Legal business name Divenere, Debra M
Credentials APRN, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376559492 NPPES
Connecticut MEDICAID 004224036

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