Mr. Benjamin Joseph Mahoney
Nurse Practitioner - Primary Care
1 Long Wharf Dr Ste 321
New Haven
, Connecticut 06511-5991
Mr. Benjamin Joseph Mahoney
Nurse Practitioner - Primary Care
1 Long Wharf Dr Ste 321
New Haven
, Connecticut 06511-5991
(203) 781-4600
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Mr. Benjamin Joseph Mahoney
- 1 Long Wharf Dr Ste 321
- New Haven, CT
- Zip : 06511-5946
- Phone : (203) 781-4600
Second Address
- Mr. Benjamin Joseph Mahoney
- 1 Long Wharf Dr Ste 321
- New Haven, CT
- Zip : 06511-5991
- Phone : (203) 781-4600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | 009732 | CT |
National Provider Identifier
| NPI | 1033788237 |
|---|---|
| Provider Name | Mr. Benjamin Joseph Mahoney |
| First Address | New Haven, CT 06511-5946 |
| Second Address | New Haven, CT 06511-5991 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2021 |
| Last Update Date | 24/01/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 004217099 | (05) | CT |
| 008039745 | (05) | CT |
| 008056033 | (05) | CT |
| 008056168 | (05) | CT |
| 008068298 | (05) | CT |
| 008103793 | (05) | CT |
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.