Dejesus, Mahalia T

Dejesus, Mahalia T is an sole proprietor health care provider with primary practice located at 7 Cambridge Dr Ste 201 , Trumbull CT 06611-4763. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dejesus, Mahalia T can be contacted via phone (203) 335-0195.

Contact Information

Primary practice address
7 Cambridge Dr Ste 201 Trumbull CT 06611-4763
Phone: (203) 335-0195
Fax: (203) 335-7293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 003347 Connecticut

Profile Details

NPI number 1578512323
LBN Legal business name Dejesus, Mahalia T
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2006
Last updated Feb 18th, 2022 - about 3 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 1578512323 NPPES
Connecticut MEDICAID 1578512323
Connecticut MEDICAID 004261799

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