ELISE HETTENBACH (NPI# 1104432996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104432996 |
| Entity Type | Individual |
| Full Name | ELISE HETTENBACH |
| Practice Address |
789 Howard Ave New Haven CT 06519-1304 |
| Practice Telephone | 8884610106 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
231117 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
789 HOWARD AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558359752 | Rachel J Lampert | Internal Medicine | 789 Howard Ave, Dana Building -3 Rd Floor, New Haven, CT 06519-1304 | 2005-10-11 |
| 1730794272 | Jennifer Colon | Pharmacist | 789 Howard Ave, New Haven, CT 06519-1300 | 2020-09-11 |
| 1184153561 | Renee Rosa Kim | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06510 | 2017-06-08 |
| 1366971293 | Nanthiya Sujijantarat | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-06-05 |
| 1033646492 | Fatimah Audu | Emergency Medicine | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-05-16 |
| 1447787064 | Aaron David Bennett | Pediatrics | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-05-13 |
| 1396289211 | Christopher Barrett | Dietitian, Registered | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-12-12 |
| 1629427000 | Jesse Humm | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-06-07 |
| 1386092153 | Zehra Omer | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, Ynhh, Dept of Medicine, New Haven, CT 06519-1304 | 2016-06-02 |
| 1144678004 | Daley Marie Ford-matz | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
| Find all providers in zip 06519 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710502810 | Ashley Stier | Nurse Practitioner | 58516 River Oaks Drive, New Haven, MI 48048-3329 | 2020-06-15 |
| 1396368676 | You Ri Hwang | Nurse Practitioner | 1050 State St, New Haven, CT 06511-2762 | 2020-05-21 |
| 1346707460 | Corbin Health Services | Nurse Practitioner | 50 Brewery St Unit 9658, New Haven, CT 06536-0658 | 2019-02-25 |
| 1235656042 | Jennifer L Cornell | Nurse Practitioner | 333 Cedar St # 2073, New Haven, CT 06510-3206 | 2017-08-23 |
| 1609317080 | Deirdre Gruber | Nurse Practitioner | 54 Meadow St Fl 9, New Haven, CT 06519-1719 | 2017-03-17 |
| 1134666076 | Sharon Corbin | Nurse Practitioner | 635 Elm St, New Haven, CT 06511-4136 | 2017-01-31 |
| 1902285976 | Mary Sytek | Nurse Practitioner | 110 Hemlock Rd, New Haven, CT 06515-2618 | 2015-05-23 |
| 1053706499 | Suzanna Smaldone | Nurse Practitioner | 1427 Chapel St., Sanjay Aggarwal Md LLC, New Haven, CT 06511-4403 | 2015-04-02 |
| 1497155634 | Cheryl Maenza | Nurse Practitioner | 789 Howard Ave Bldg 3, New Haven, CT 06519-1304 | 2014-08-25 |
| 1881922482 | Chantelle Marie Shimono-legault | Nurse Practitioner | 330 Cedar St Tmp3, New Haven, CT 06510-3218 | 2009-11-20 |
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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.