Individual
MRS. KELLY MORAN HAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4740
Mailing address
20 YORK STREET, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4740
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001250
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970002505
MEDICARE PROVIDER NUMBER
CT
Enumeration date
05/31/2007
Last updated
06/20/2016
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