Maciejak, Nicole Langan

Maciejak, Nicole Langan is an individual health care provider with primary practice located at 35 Davis Street Sbhc, New Haven CT 06515-1601. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Maciejak, Nicole Langan can be contacted via phone (475) 220-7815.

Contact Information

Primary practice address
35 Davis Street Sbhc New Haven CT 06515-1601
Phone: (475) 220-7815
Fax: (475) 220-7842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 3454 Connecticut

Profile Details

NPI number 1174694798
LBN Legal business name Maciejak, Nicole Langan
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Nov 13th, 2019 - about 6 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 1174694798 NPPES
Connecticut MEDICAID 004271821

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