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Individual

MR. JOHN DEMAYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, SUITE 321, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7374
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004082286
CT
05
008022626
CT
05
500000315
CT
Enumeration date
01/27/2014
Last updated
01/24/2022
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