Mahoney, Benjamin Joseph

Mahoney, Benjamin Joseph is an sole proprietor health care provider with primary practice located at 1 Long Wharf Dr Ste 321 , New Haven CT 06511-5991. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as his primary health care specialty. Mahoney, Benjamin Joseph can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
1 Long Wharf Dr Ste 321 New Haven CT 06511-5991
Phone: (203) 781-4600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 009732 Connecticut

Profile Details

NPI number 1033788237
LBN Legal business name Mahoney, Benjamin Joseph
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2021
Last updated Jan 24th, 2022 - about 2 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 1033788237 NPPES
Connecticut MEDICAID 008056168
Connecticut MEDICAID 008039745
Connecticut MEDICAID 008056033
Connecticut MEDICAID 008103793
Connecticut MEDICAID 004217099
Connecticut MEDICAID 008068298

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