Wallis, Kristen S

Wallis, Kristen S is an individual health care provider with primary practice located at 299 Washington Ave , Hamden CT 06518-3026. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallis, Kristen S can be contacted via phone (203) 288-4288.

Contact Information

Primary practice address
299 Washington Ave Hamden CT 06518-3026
Phone: (203) 288-4288
Fax: (855) 414-4010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 244100 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 046513 Connecticut

Profile Details

NPI number 1568662492
LBN Legal business name Wallis, Kristen S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2007
Last updated Apr 30th, 2021 - about 3 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 1568662492 NPPES
Connecticut MEDICAID 02896880

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