LISA MARIE AMBROGIO-DECOLA (NPI# 1295741825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295741825 |
| Entity Type | Individual |
| Full Name | LISA MARIE AMBROGIO-DECOLA |
| Credential | PA |
| Practice Address |
435 Lewis Ave Ste 103 Meriden CT 06451-2101 |
| Mailing Address |
435 Lewis Ave Ste 103 Meriden CT 06451-2101 |
| Practice Telephone | 2036947550 |
| Practice Fax Number | 2036947555 |
| Mailing Telephone | 2037893997 |
| Mailing Fax Number | 2038675216 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
001246 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1450 Chapel St, New Haven, CT 065114405 | 2037893997 | 2038675216 |
| Street Address |
435 LEWIS AVE STE 103 |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| Find all providers in zip 06451 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588290613 | Isabel Nodiff | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451-2101 | 2020-03-20 |
| 1538715883 | Matthew Decaprio | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451-2101 | 2019-08-13 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1558730507 | Timothy Allen Lincoln II | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451-2101 | 2015-09-21 |
| 1407043557 | Ashley Allatin | Physician Assistant | 435 Lewis Ave, Department of Surgery, Meriden, CT 06451-2101 | 2007-10-02 |
| 1467526681 | Eileen A Tobin | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2006-11-20 |
| 1013011154 | Henry Vladyka | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451-2101 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798362 | Brandon H Kusako | Physician Assistant | 34 Maple St Dept Of, Norwalk, CT 06850-3815 | 2020-10-26 |
| 1073137097 | Page Renee Burns | Physician Assistant | 40 Bertrose Ave, Milford, CT 06460-5906 | 2020-06-05 |
| 1043848575 | Caitlin Ann Kimberly | Physician Assistant | 40 Avalon Dr Unit 6331, Milford, CT 06460-8956 | 2020-03-30 |
| 1699307199 | Lindy Carelli | Physician Assistant | 330 Washington St Ste 410, Norwich, CT 06360-2700 | 2020-02-12 |
| 1174166722 | Jacqueline Clarizio | Physician Assistant | 5520 Park Ave Ste 300, Trumbull, CT 06611-3465 | 2019-10-25 |
| 1699260109 | Kristen Jean Mosher | Physician Assistant | 31 Cloverdale Ave, Shelton, CT 06484-2538 | 2018-06-27 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1962920561 | Eugenie Cho | Physician Assistant | 34 Maple St., Norwalk, CT 06856 | 2017-09-03 |
| 1134536311 | Allyson E Kubasek | Physician Assistant | 32 Seymour Street, Hartford Hospital Orthopedics Dept, Hartford, CT 06102-5037 | 2014-07-19 |
| 1477964344 | Samuel Silva | Physician Assistant | 226 White St., Danbury, CT 06810 | 2014-05-14 |
| Find all providers with the same taxonomy | ||||
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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.