Healthcare Provider Details
I. General information
NPI: 1043426687
Provider Name (Legal Business Name): MEJIAS HEALTH & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2007
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 OLD PARK LANE RD SUITE 3
NEW MILFORD CT
06776-2923
US
IV. Provider business mailing address
1 OLD PARK LANE RD SUITE 3
NEW MILFORD CT
06776-2923
US
V. Phone/Fax
- Phone: 860-355-8494
- Fax: 860-354-9468
- Phone: 860-355-8494
- Fax: 860-354-9468
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 001495 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
NESTOR
MEJIAS
Title or Position: OWNER/OPERATOR
Credential: DC
Phone: 860-355-8494