Graham, Mary Lou

Graham, Mary Lou is an sole proprietor health care provider with primary practice located at 45 Russell St , New Britain CT 06052-1312. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Graham, Mary Lou can be contacted via phone (860) 612-0432.

Contact Information

Primary practice address
45 Russell St New Britain CT 06052-1312
Phone: (860) 612-0432
Fax: (860) 612-0087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 003146 Connecticut

Profile Details

NPI number 1811995103
LBN Legal business name Graham, Mary Lou
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2005
Last updated Oct 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811995103 NPPES
Connecticut Other 2070747 CIGNA
Connecticut Other 112425000 CIGNA
Connecticut Other 500002055 CIGNA

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