Healthcare Provider Details

I. General information

NPI: 1760416226
Provider Name (Legal Business Name): STEPHANIE L. ARLIS-MAYOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 N MAIN ST
BRANFORD CT
06405-3061
US

IV. Provider business mailing address

2 BARNES INDUSTRIAL RD S
WALLINGFORD CT
06492-2486
US

V. Phone/Fax

Practice location:
  • Phone: 203-483-2509
  • Fax: 203-483-2513
Mailing address:
  • Phone: 203-626-0160
  • Fax: 203-294-6734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number034803
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number034803
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: