Mahoney, Casey E.
Mahoney, Casey E. is an individual health care provider with primary practice located at 305 Western Blvd Ste 100 , Glastonbury CT 06033-4380. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mahoney, Casey E. can be contacted via phone (860) 522-0604.Contact Information
Primary practice address
305 Western Blvd Ste 100
Glastonbury CT 06033-4380
Phone: (860) 522-0604
Fax: (860) 659-2652
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 7367 | Connecticut |
Profile Details
NPI number | 1750829693 |
---|---|
LBN Legal business name | Mahoney, Casey E. |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 10th, 2017 |
Last updated | Apr 5th, 2018 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750829693 | NPPES |
Massachusetts | MEDICAID | 110121424A | |
Massachusetts | MEDICAID | 04697090 | |
Massachusetts | MEDICAID | 1029983 |
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