Shannon Blake in Manchester - Physician Assistant
Shannon Blake - NPI 1578509238
Shannon Blake is a Physician Assistant in Manchester, Connecticut. Shannon Blake practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Shannon Blake is 1578509238. The last update date is 2011-07-28.
Shannon Blake's current location address is 229 Henry St, Manchester, Connecticut. You can contact this provider via phone number 8603715335. The mailing address for Shannon Blake is 229 Henry St, Manchester, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Blake |
|---|---|
| Address | 229 Henry St, Manchester, Connecticut |
| Phone Number | 8603715335 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1578509238 |
|---|---|
| Provider Enumeration Date | 2006-06-21 |
| Last Updated Date | 2011-07-28 |
Provider Mailing Address Detail
| Address | 229 Henry St |
|---|---|
| City | Manchester |
| State | Connecticut (CT) |
| Post Code | 60423243 |
| Phone Number | 8603715335 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1550 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Post Comment/ Review Below
What is the Shannon Blake's 1578509238?
The Shannon Blake's NPI (National Provider Identifier) Number is 1578509238. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Shannon Blake is located?
The Shannon Blake is situated at the following address: 229 Henry St, Manchester, CT, 60423243.
What is the Shannon Blake's area of specialization and corresponding taxonomy classification?
The Shannon Blake's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date was the 1578509238 assigned to Shannon Blake?
The Shannon Blake was issued its 1578509238 on 2006-06-21, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Shannon Blake, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Shannon Blake, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-07-28.
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