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General NPI Number Information
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NPI Number | 1235993783
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Entity Type | Individual
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Provider Name | ANEJAH MCLAURIN
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Gender | Female
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 180 FAIRFIELD AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4252
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Country | US
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Telephone | 203-394-6529
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Fax |
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Provider Business Mailing Address
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Address Line | 160 PUTNAM AVE
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City | HAMDEN
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State | CT
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Zip | 06517-2737
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Country | US
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Telephone | 910-315-5213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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