Provider Demographics
NPI:1679322671
Name:MELLA SOARES PESSOA, BEATRIZ (MD)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:MELLA SOARES PESSOA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1921
Mailing Address - Country:US
Mailing Address - Phone:860-679-2147
Mailing Address - Fax:860-679-4624
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:UCONN HEALTH
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-1921
Practice Address - Country:US
Practice Address - Phone:860-679-2562
Practice Address - Fax:860-679-4613
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program