Charlene Roberta Th Criss in New London - Medical
Charlene Roberta Th Criss - NPI 1760469514
Charlene Roberta Th Criss is a Medical in New London, Connecticut. Charlene Roberta Th Criss practices all healthcare services and medical treatments related to Medical. The NPI Number for Charlene Roberta Th Criss is 1760469514. The last update date is 2020-04-29.
Charlene Roberta Th Criss's current location address is 15 Mohegan Ave, New London, Connecticut. You can contact this provider via phone number 8607016737 and fax number 8607016475. The mailing address for Charlene Roberta Th Criss is 15 Mohegan Ave, New London, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charlene Roberta Th Criss |
|---|---|
| Address | 15 Mohegan Ave, New London, Connecticut |
| Phone Number | 8607016737 |
| Fax Number | 8607016475 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1760469514 |
|---|---|
| Provider Enumeration Date | 2005-12-22 |
| Last Updated Date | 2020-04-29 |
Provider Mailing Address Detail
| Address | 15 Mohegan Ave |
|---|---|
| City | New London |
| State | Connecticut (CT) |
| Post Code | 6320 |
| Phone Number | 8607016737 |
| Fax Number | 8607016475 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 1710 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1051820 | NATIONAL COMMISSION ON CERTIFI | ||
| 1831 | CT | PHYSICIAN ASSISTANT |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Charlene Roberta Th Criss by the Centers for Medicare & Medicaid Services?
The Charlene Roberta Th Criss has been issued the NPI (National Provider Identifier) 1760469514, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Charlene Roberta Th Criss is geographically located?
The Charlene Roberta Th Criss is physically situated at the following location: 15 Mohegan Ave, New London, CT, 6320.
What is Charlene Roberta Th Criss's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Charlene Roberta Th Criss is Medical, and the taxonomy code that classifies this field of practice is 363Am0700X.
When was the Charlene Roberta Th Criss's 1760469514 issued?
The Charlene Roberta Th Criss's 1760469514 was issued on 2005-12-22.
As of what date was the information regarding Charlene Roberta Th Criss, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Charlene Roberta Th Criss, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-04-29.