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CLARISSE MELINDA FONG SAN JUAN MD NPI 1245750132


NPI Information

NPI: 1245750132
Provider Name: CLARISSE MELINDA FONG SAN JUAN, MD
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Individual

Specialization: Pain Medicine

PECOS Registration: Yes

Address:
20 YORK ST
NEW HAVEN, CT
ZIP 06510
Phone: (203) 688-4242
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Clarisse Melinda Fong San Juan, MD is a pain medicine physical medicine rehabilitation in New Haven, CT with 7 years of experience. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. Clarisse Melinda Fong San Juan, MD NPI is 1245750132. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

20 YORK ST
NEW HAVEN, CT
ZIP 06510-220
Phone: (203) 688-4242

The NPI 1245750132 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 6/22/2017 and was last updated on 8/18/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208100000XPhysical Medicine & Rehabilitation72590CONNECTICUTNo
22081P2900XPhysical Medicine & RehabilitationPain Medicine72590CONNECTICUTYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.