Individual
MARIO ENRIQUE OCHOA PRIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
(203) 777-8506
Mailing address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
(203) 777-8506
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
63765
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008097068
—
CT
Enumeration date
06/13/2016
Last updated
12/28/2020
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