Provider Demographics
NPI:1922067388
Name:PERSINGER, MOLLY FEY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:FEY
Last Name:PERSINGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CHRISTINE
Other - Last Name:FEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:YNHH SOUTH PAVILION - ROOM 218
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:203-688-2222
Mailing Address - Fax:203-785-4580
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:YNHH SOUTH PAVILION - ROOM 218
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2222
Practice Address - Fax:203-785-4580
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236164Medicaid