Long, Chrystal T

Long, Chrystal T is an individual health care provider with primary practice located at 415 Main St , West Haven CT 06516-4296. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Long, Chrystal T can be contacted via phone (203) 931-1184.

Contact Information

Primary practice address
415 Main St West Haven CT 06516-4296
Phone: (203) 931-1184
Fax: (203) 931-1184
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2045 Connecticut

Profile Details

NPI number 1477716728
LBN Legal business name Long, Chrystal T
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2008
Last updated Apr 6th, 2011 - about 15 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 1477716728 NPPES
Connecticut MEDICAID 004235918

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