Elizabeth Magenheimer
Nurse Practitioner - Community Health
374 Grand Avenue Fair Haven Community Health Ctr
New Haven
, Connecticut 06513
Elizabeth Magenheimer
Nurse Practitioner - Community Health
374 Grand Avenue Fair Haven Community Health Ctr
New Haven
, Connecticut 06513
(203) 787-1383
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About
Features
Specialties
- Nurse Practitioner - Community Health
Languages spoken
- English
Location
First Address
- Elizabeth Magenheimer
- 120 Huntington Street
- New Haven, CT
- Zip : 06511
- Phone : (203) 787-1383
Second Address
- Elizabeth Magenheimer
- 374 Grand Avenue Fair Haven Community Health Ctr
- New Haven, CT
- Zip : 06513
- Fax : (203) 777-8506
- Phone : (203) 777-7411
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC1500X | Nurse Practitioner - Community Health | 000756 | CT |
National Provider Identifier
| NPI | 1093819146 |
|---|---|
| Provider Name | Elizabeth Magenheimer |
| First Address | New Haven, CT 06511 |
| Second Address | New Haven, CT 06513 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/09/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 183832 | WELLCARE (01) | |
| 756000 | CT CARE (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.