Basic Information
Provider Information
NPI: 1407587041
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARBELAEZ LINERO
FirstName: MARIA JULIANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 116 SOUTH ST
Address2:  
City: WEST HAVEN
State: CT
PostalCode: 065167149
CountryCode: US
TelephoneNumber: 2035870226
FaxNumber:  
Practice Location
Address1: 20 YORK ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065103220
CountryCode: US
TelephoneNumber: 2036884242
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2022
LastUpdateDate: 08/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X146340CTN Nursing Service ProvidersRegistered Nurse 
363LF0000X10749CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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