Healthcare Provider Details

I. General information

NPI: 1831838291
Provider Name (Legal Business Name): JOY MIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEMINGWAY AVE STE 3
EAST HAVEN CT
06512-3000
US

IV. Provider business mailing address

300 HEMINGWAY AVE STE 3
EAST HAVEN CT
06512-3000
US

V. Phone/Fax

Practice location:
  • Phone: 203-469-5644
  • Fax:
Mailing address:
  • Phone: 203-469-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number008954
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: