Memisevich, Edin

Memisevich, Edin is an individual health care provider with primary practice located at 1 Long Wharf Dr , New Haven CT 06511-5946. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is his primary health care specialty. Memisevich, Edin can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
1 Long Wharf Dr New Haven CT 06511-5946
Phone: (203) 781-4600
Fax: (203) 781-4624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6411 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 6411 Connecticut

Profile Details

NPI number 1992160105
LBN Legal business name Memisevich, Edin
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2015
Last updated Jan 9th, 2017 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1992160105 NPPES
Connecticut MEDICAID 008056168
Connecticut Other 008063396
Connecticut MEDICAID 004217099
Connecticut MEDICAID 008056033

Popular Providers