Individual
MAHALIA T DEJESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
7 CAMBRIDGE DR STE 201, TRUMBULL, CT 06611-4763
(203) 335-0195
(203) 335-7293
Mailing address
7 CAMBRIDGE DR STE 201, TRUMBULL, CT 06611-4763
(203) 335-0195
(203) 335-7293
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
003347
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004261799
—
CT
05
—
1578512323
—
CT
Enumeration date
05/09/2006
Last updated
02/18/2022
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