Healthcare Provider Details

I. General information

NPI: 1316341829
Provider Name (Legal Business Name): CHRISTINA NOEL MAHLSTEDT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 WASHINGTON AVE STE LL
HAMDEN CT
06518-3039
US

IV. Provider business mailing address

299 WASHINGTON AVE STE LL
HAMDEN CT
06518-3039
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-4288
  • Fax: 855-414-4010
Mailing address:
  • Phone: 203-288-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003205
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: