Individual
LUIZ MARACAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 785-2802
(203) 785-6664
Mailing address
333 CEDAR STREET, TMP 3, NEW HAVEN, CT 06512
(203) 785-2802
(203) 785-6664
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
051620
CT
207L00000X
Anesthesiology Physician
Q0751
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051620
CONNECTICUT STATE LICENSE
CT
05
—
340890801
—
TX
01
—
Q0751
TEXAS STATE LICENSE
TX
Enumeration date
08/05/2011
Last updated
06/23/2020
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