Samira Fisayo
Nurse Anesthetist, Certified Registered in New London, CT. Individual provider (NPI-1).
NPI number1740851112
StatusActive
Last updated in NPPESJul 7, 2021
Details
- NPI
- 1740851112
- Entity type
- Individual (NPI-1)
- Name
- Samira Fisayo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 7, 2021
- Certification date
- Jun 16, 2021
- Last updated
- Jul 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 9774 | CT | Yes |
Practice location
365 Montauk AveNew London, CT 06320-4769
Phone 860-442-0711
Mailing address
725 Nortontown RdGuilford, CT 06437-4728
Phone 203-747-9858
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