PATRICK J CREEDON (NPI# 1295836104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295836104 |
| Entity Type | Individual |
| Full Name | PATRICK J CREEDON |
| Credential | PA-C |
| Practice Address |
28 Crescent St Middlesex Hospital Middletown CT 06457-3654 |
| Practice Telephone | 8603586394 |
| Mailing Telephone | 8603584820 |
| Mailing Fax Number | 8603588661 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 001265 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
001265 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 003012655 | 05 |
| Street Address |
28 CRESCENT ST MIDDLESEX HOSPITAL |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788859 | Eric B Neadel | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2005-05-23 |
| 1861001729 | Adrianne Lynn Wyckoff | Registered Nurse | 28 Crescent St, Middletown, CT 06457-3650 | 2020-07-27 |
| 1639791577 | Peder Johnsen | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457-3654 | 2020-05-14 |
| 1275171530 | Lisa Ann Tringali | Recreation Therapist | 28 Crescent St, Middletown, CT 06457-3654 | 2019-12-18 |
| 1528600160 | Antonella Rosa Sferrazza | Counselor | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-15 |
| 1548801830 | Michael Tammaro | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-08 |
| 1699240705 | Mary Theresa Doyle | Social Worker | 28 Crescent St, Middletown, CT 06457-3650 | 2018-10-05 |
| 1649761040 | Emily Eklof | Nurse Practitioner | 28 Crescent St, Middletown, CT 06457 | 2018-05-22 |
| 1285141077 | Christine O'grady | Social Worker | 28 Crescent St, Middletown, CT 06457-3654 | 2018-01-03 |
| 1871022293 | Jacqueline Mary Atkinson | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2017-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649278540 | Kyle R Brown | Physician Assistant | 540 Saybrook Rd, Suite 160, Middletown, CT 06457-4711 | 2005-07-13 |
| 1629698717 | Brian P Dudgeon | Physician Assistant | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2020-04-20 |
| 1548801830 | Michael Tammaro | Physician Assistant | 28 Crescent St, Middletown, CT 06457-3654 | 2019-10-08 |
| 1447811294 | Julia E. Byman | Physician Assistant | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2019-06-24 |
| 1568939775 | Logan Z Reisenbigler | Physician Assistant | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2018-10-25 |
| 1528540127 | Maneesh Pal | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2018-08-30 |
| 1821462086 | Gabriel Anthony Godart | Physician Assistant | 480 Red Hill Rd, Middletown, NJ 07748-3052 | 2015-11-25 |
| 1366837056 | Katherine Erikson | Physician Assistant | 410 Saybrook Rd, Suite 100, Middletown, CT 06457-4777 | 2015-03-31 |
| 1508262619 | Erica Joy Nicholson | Physician Assistant | 707 E Main St, Middletown, NY 10940-2650 | 2014-11-17 |
| 1982008108 | Brian Beltrani | Physician Assistant | 512 Saybrook Rd, Middletown, CT 06457-4788 | 2014-10-17 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on PATRICK J CREEDON.
| 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.