Healthcare Provider Details

I. General information

NPI: 1225703150
Provider Name (Legal Business Name): MELISSA JANE ALOGNA RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA JANE SZOSTEK

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 COLUMBUS AVE
NEW HAVEN CT
06519-1233
US

IV. Provider business mailing address

428 COLUMBUS AVE
NEW HAVEN CT
06519-1233
US

V. Phone/Fax

Practice location:
  • Phone: 203-503-3000
  • Fax:
Mailing address:
  • Phone: 203-503-3047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number9336
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: