MS. SHAHANA LEE THERIAULT


Address: 9 Washington Ave, Hamden, CT 06518-3267
Phone: 2038656784

MS. SHAHANA LEE THERIAULT (NPI# 1114322153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114322153
Entity Type Individual
Full Name MS. SHAHANA LEE THERIAULT
Credential PA-C
Practice Address 9 Washington Ave
Hamden
CT 06518-3267
Practice Telephone 2038656784
Practice Fax Number 2038656788
Mailing Telephone 2038656784
Mailing Fax Number 2038656788
Enumeration Date 2014-11-04
Last Update Date 2016-07-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 3231 CT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 1114322153 05

Office Location

Street Address 9 WASHINGTON AVE
City HAMDEN
State CT
Zip Code 06518-3267

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043216575 Louis Iorio Orthopaedic Surgery 9 Washington Ave, Hamden, CT 06518-3267 2005-06-21
1346621612 Sandra Byrnes Nurse Practitioner 9 Washington Ave, Hamden, CT 06518-3267 2015-06-12
1598178428 Connecticut Orthopaedic Specialists, PC Occupational Therapist 9 Washington Ave, Hamden, CT 06518-3267 2014-06-09
1770995698 Connecticut Orthopaedic Specialists, PC Internal Medicine 9 Washington Ave, Hamden, CT 06518-3267 2014-05-27
1881005692 Jeeten Singha Podiatrist 9 Washington Ave, Hamden, CT 06518 2014-05-14
1437591971 Randall L Owen Physician Assistant 9 Washington Ave, Hamden, CT 06518-3267 2013-07-25
1912286295 Maria Rose Longobardi Hague Physical Therapist 9 Washington Ave, Hamden, CT 06518-3267 2011-08-04
1174842546 Rachel Boyarsky Pediatrics 9 Washington Ave, Hamden, CT 06518-3267 2010-05-25
1558590349 Krista Fiorentino Nolan Physical Therapist 9 Washington Ave, Hamden, CT 06518-3267 2009-07-14
1558505628 Eman Saeed Physician Assistant 9 Washington Ave, Hamden, CT 06518-3267 2009-04-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1871082032 Lynne Severance Registered Nurse 121 Highland Ave, Hamden, CT 06518 2018-05-03
1912446782 Associates In Medical & Cosmetic Dermatology, PC Dermatology 9 Washington Avenue, Hamden, CT 06518 2017-02-14
1700338738 The Lasik Vision Institute LLC Clinic/Center 2313 Whitney Avenue, Suite 1b, Hamden, CT 06518 2016-10-25
1639441934 Michael Tonkyu Kim Dentist 2880 Old Dixwell Ave., Hamden, CT 06518 2012-02-01
1174751598 Yetsa Adebodunde Tuakli-wosornu Physical Medicine & Rehabilitation 2080 Whitney Ave Ste 280, Hamden, CT 06518 2009-06-24
1619112133 Priority Healthcare, LLC Home Health 12213 Town Walk Drive, Hamden, CT 06518 2008-12-12
1306095864 Uttampal Singh Dentist 2832 Whitney Avenue- Advanced Orthodontics LLC, Suite- A, Hamden, CT 06518 2008-09-09
1790942100 Wellcare of Connecticut, Inc. Health Maintenance Organization 2319 Whitney Avenue, 6th Floor, Hamden, CT 06518 2008-05-22
1720295165 Susan Norkus Specialist/Technologist 275 Mt. Carmel Ave., Quinnipiac University, Hamden, CT 06518 2007-05-16
1447385620 Fritz & Hawley Vision Center Technician/Technologist 2313 Whitney Ave, Suite 1d, Hamden, CT 06518 2007-02-21
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy 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 perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740836766 Christina Ferneini Physician Assistant 10 Breckenridge Ct, Hamden, CT 06514-1529 2019-08-15
1174008320 Janelle Grizzle Physician Assistant 8102 Town Walk Dr, Hamden, CT 06518-3715 2018-10-03
1013491349 Nina Tufaro Physician Assistant 925 Mix Ave Apt 1d, Hamden, CT 06514-5151 2018-09-22
1649655226 Shahin Shaikh Physician Assistant 2 Skiff St Apt 311, Hamden, CT 06514-1822 2015-07-24
1053689489 Wanda Bronstein Physician Assistant Internal Medicine of Greater New Haven, 1952 Whitney Ave, Hamden, CT 06517 2011-12-13
1003197039 Carly Rumanoff Physician Assistant 3588 Whitney Ave, Hamden, CT 06518-1920 2011-09-04
1598904161 Stephanie Benedict Parrillo Physician Assistant 2560 Dixwell Ave Ste 2b, Hamden, CT 06514-1852 2009-02-05
1285870121 Jennifer Pielech Physician Assistant 9 Washington Ave Ste 3a, Hamden, CT 06518-3267 2008-12-24
1134304017 Richard Elliott Chen Physician Assistant 27331 Town Walk Dr, Hamden, CT 06518-3777 2008-01-09
1073580833 Marcy Ann Carrera Physician Assistant 275 Mount Carmel Ave Bldg 4, Hamden, CT 06518-1905 2006-03-01
Find all providers in HAMDEN

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City HAMDEN
Zip Code 06518

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Dataset Information

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.

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