MS. MARYBETH AUCOIN MOORE (NPI# 1033389192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033389192 |
| Entity Type | Individual |
| Full Name | MS. MARYBETH AUCOIN MOORE |
| Credential | PA-C, MPH |
| Practice Address |
631 Quaker Ln S West Hartford CT 06110-1026 |
| Practice Telephone | 8602335133 |
| Practice Fax Number | 8602335212 |
| Mailing Telephone | 8602335133 |
| Mailing Fax Number | 8602335212 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2012-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002729 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | LICENSE | 002729 | 01 |
| Street Address |
631 QUAKER LN S |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06110-1026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578509238 | Shannon Blake | Physician Assistant | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2006-06-21 |
| 1538687884 | Meghan Philips | Nurse Practitioner | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2017-09-07 |
| 1770959496 | Julia Fitzpatrick | Physical Therapist | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2015-08-17 |
| 1508263617 | Rachel Glantz | Physician Assistant | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2014-12-04 |
| 1578973905 | Alexandra N Schain | Nurse Practitioner | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2014-05-07 |
| 1225464233 | Sarah Elizabeth Schauer | Nurse Practitioner | 631 Quaker Ln S, West Hartford, CT 06110 | 2013-09-23 |
| 1730315458 | Angela Stein | Internal Medicine | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2009-06-09 |
| 1538395603 | Kylee Ann Violette | Physical Therapist | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2009-06-03 |
| 1548417512 | Patricia Conlon Rickart | Physical Therapist | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2008-08-21 |
| 1124130059 | Kristin L Meyer | Nurse Practitioner | 631 Quaker Ln S, West Hartford, CT 06110-1026 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306467030 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1500 New Britain Ave, H216, West Hartford, CT 06110 | 2020-05-05 |
| 1962903492 | Mitchell Graham | Chiropractor | 121 Talcott Rd, West Hartford, CT 06110 | 2018-02-21 |
| 1417302829 | Kaitlyn Roggi | Behavioral Analyst | 101 South St Fl 2, West Hartford, CT 06110 | 2016-05-04 |
| 1487036802 | Nino Gigauri | Internal Medicine | 114 Woodlawn St, Hartford, CT 06110 | 2015-06-22 |
| 1093082174 | Shital Makati | Pharmacist | 940 South Quaker Lane, West Hartford, CT 06110 | 2011-11-17 |
| 1376842948 | Kenneth Reeve | Pediatrics | 1459a New Britain Ave, West Hartford, CT 06110 | 2011-03-22 |
| 1225368913 | Jenny Alzate Lpc LLC | Counselor | 78 Cambridge St, West Hartford, CT 06110 | 2010-01-04 |
| 1821200957 | Advocate Community Care Agency, Inc. | Home Delivered Meals | 1086 New Britain Ave, West Hartford, CT 06110 | 2007-05-03 |
| 1730257155 | Catherine Ann Staunton | Physical Therapist | 1350 Chapel Street, New Haven, CT 06110 | 2006-12-01 |
| 1689750002 | Pamela M Matuszewski | Optometrist | 1445 New Britain Ave, W Hartford, CT 06110 | 2006-10-27 |
| Find all providers in zip 06110 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558679381 | Megan Rourke | Physician Assistant | 1245 New Britain Ave, West Hartford, CT 06110-2404 | 2010-09-14 |
| 1063064665 | Maeghan Molly Chapman | Physician Assistant | 65 Memorial Rd Ste 508, West Hartford, CT 06107-4233 | 2019-07-13 |
| 1235799503 | Lauren Catherine Shaw | Physician Assistant | 1030 Boulevard, West Hartford, CT 06119-1801 | 2019-06-18 |
| 1619473709 | Olivia Caroline Dellostritto | Physician Assistant | 836 Farmington Ave Ste 207, West Hartford, CT 06119-1551 | 2018-04-05 |
| 1215002779 | Janis A. Jaquez | Physician Assistant | 74 Park Rd, West Hartford, CT 06119-1853 | 2006-11-21 |
| 1639194863 | Jessica M Borkowski | Physician Assistant | 336 N Main St, West Hartford, CT 06117-2510 | 2006-07-12 |
| 1659338101 | Maureen Elizabeth Morris | Physician Assistant | 445 S Main St, West Hartford, CT 06110-1646 | 2006-04-27 |
| 1316906258 | Adam E Kovalski | Physician Assistant | 445 S Main St, West Hartford, CT 06110-1646 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163671 | Kirsten Alexandra Drobiak | Physician Assistant | 37 Jennifer Ln, Griswold, CT 06351-3500 | 2020-10-28 |
| 1255955019 | Amanda Uscilla | Physician Assistant | 20 Hilltop Rd, Bethany, CT 06524-3514 | 2020-06-07 |
| 1689208571 | Sage Ann Miele | Physician Assistant | 149 Water St Apt 32, Norwalk, CT 06854-3758 | 2020-02-28 |
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1811547508 | Gabriela M Vargas | Physician Assistant | 24 Hospital Ave # Tower7, Danbury, CT 06810-6099 | 2019-09-16 |
| 1275192049 | Molly J Mable | Physician Assistant | 282 Washington St Fl 1, Hartford, CT 06106-3322 | 2019-06-06 |
| 1003377631 | Stephan Anton Bayer | Physician Assistant | 205 Elm St Apt 5, West Haven, CT 06516-4659 | 2019-03-27 |
| 1578024105 | Vance P Baughman | Physician Assistant | 325 Lafayette St Unit 1003, Bridgeport, CT 06604-5472 | 2019-03-27 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
| City | WEST HARTFORD |
| Zip Code | 06110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.