Mimi Mah, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042186 Issued in CT

Practice address

60 Washington Ave
Suite 304
Hamden, CT 06518

Phone

(203) 281-2890

Fax

(203) 281-2896

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spectrum Psychiatric Group PC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Hamden, CT
  • NPI 1518142058
  NPD (past)
• Spectrum Psychiatric Group PC

  • Psychiatry Physician
  • Hamden, CT
  • NPI 1558420653
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831103209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WASHINGTON AVE",
            "address_2": "SUITE 304",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518",
            "telephone_number": "203-281-2890",
            "fax_number": "203-281-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WASHINGTON AVE",
            "address_2": "SUITE 304",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518",
            "telephone_number": "203-281-2890",
            "fax_number": "203-281-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAH",
        "first_name": "MIMI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "042186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U01421867",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olyssa Mack
• Lisa Mackres, ICSW
• Rosemary Macniven, LCSW
• Gina Rose Macolino Petrucci, L.C.S.W
• Regina J Magnetti, LCSW
• Kelly Mahan, LADC, LPCA
• Lyndsey Michele Maher, ND
• Christina Noel Mahlstedt, PA-C
• Moira Mahon, LMFT
• Amanda Marie Majkutowski, PHARMD.

• Psychiatry Physician in Hamden, CT
• Providers in Hamden, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.