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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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