Individual
MARIA MAULDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
374 GRAND AVE, FAIR HAVEN COMMUNITY HEALTH CTR, NEW HAVEN, CT 06511
(203) 777-7411
(203) 777-8506
Mailing address
1976 CHAPEL ST, NEW HAVEN, CT 06515
(203) 387-7537
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
000435
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004359734
CTCXRE
—
05
—
004235736
—
CT
01
—
400000435CT
ANTHEM BCBS
—
Enumeration date
09/11/2006
Last updated
07/08/2007
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