Mahoney, Casey E.

Mahoney, Casey E. is an individual health care provider with primary practice located at 305 Western Blvd Ste 100 , Glastonbury CT 06033-4380. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mahoney, Casey E. can be contacted via phone (860) 522-0604.

Contact Information

Primary practice address
305 Western Blvd Ste 100 Glastonbury CT 06033-4380
Phone: (860) 522-0604
Fax: (860) 659-2652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 7367 Connecticut

Profile Details

NPI number 1750829693
LBN Legal business name Mahoney, Casey E.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2017
Last updated Apr 5th, 2018 - about 8 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 1750829693 NPPES
Massachusetts MEDICAID 110121424A
Massachusetts MEDICAID 04697090
Massachusetts MEDICAID 1029983

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