Fahey, Diane E

Fahey, Diane E is an individual health care provider with primary practice located at 755 Campbell Ave Suite 2, West Haven CT 06516-3715. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Fahey, Diane E can be contacted via phone (203) 889-2297.

Contact Information

Primary practice address
755 Campbell Ave Suite 2 West Haven CT 06516-3715
Phone: (203) 889-2297
Fax: (203) 889-2249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 000373 Connecticut

Profile Details

NPI number 1144385261
LBN Legal business name Fahey, Diane E
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated May 3rd, 2016 - about 9 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 1144385261 NPPES
Connecticut MEDICAID 001177757
Connecticut Other 000373

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