NICOLE LANGAN MACIEJAK APRN NPI 1174694798

NPI Information

NPI: 1174694798
Provider Name: NICOLE LANGAN MACIEJAK, APRN
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
35 DAVIS STREET
SBHC
NEW HAVEN, CT
ZIP 06515
Phone: (475) 220-7815
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Nicole Langan Maciejak, APRN is a pediatrics nurse practitioner in New Haven, CT. Nicole Langan Maciejak, APRN NPI is 1174694798. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

35 DAVIS STREET
SBHC
NEW HAVEN, CT
ZIP 06515-601
Phone: (475) 220-7815
Fax: (475) 220-7842

The NPI 1174694798 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 11/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	3454	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004271821	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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