Provider Demographics
NPI:1225165137
Name:MISHRA, MARGARET MARTINI (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARTINI
Last Name:MISHRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 TEMPLE ST
Mailing Address - Street 2:PH8
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2711
Mailing Address - Country:US
Mailing Address - Phone:478-396-3614
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:NBSCU
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-1987
Practice Address - Fax:203-688-5784
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT003339363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics