Healthcare Provider Details

I. General information

NPI: 1194158667
Provider Name (Legal Business Name): DR. ASHLY MAUGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
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: 203-503-3183
Mailing address:
  • Phone: 203-503-3000
  • Fax: 203-503-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG069794
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number56777
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: