Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3682 | CT |
N | 363LP0200X | Nurse Practitioner - Pediatrics | F381958-1 | NY |
NPI | 1003071937 |
---|---|
Provider Name | Roberto Mejias |
First Address | New Haven, CT 06519-1369 |
Second Address | New Haven, CT 06519-1369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2008 |
Last Update Date | 09/12/2016 |