Healthcare Provider Details

I. General information

NPI: 1881386639
Provider Name (Legal Business Name): AURIS DEL PILAR MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 FISKE ST
WATERBURY CT
06710-1311
US

IV. Provider business mailing address

79 BEACON ST
WATERBURY CT
06704-3424
US

V. Phone/Fax

Practice location:
  • Phone: 718-683-6507
  • Fax:
Mailing address:
  • Phone: 203-574-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: