ELIZABETH MAE ROESSLER (NPI# 1356322358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356322358 |
| Entity Type | Individual |
| Full Name | ELIZABETH MAE ROESSLER |
| Credential | PA |
| Practice Address |
374 Grand Ave New Haven CT 06513-3733 |
| Mailing Address |
Po Box 208237 55 Lock St New Haven CT 05511 |
| Practice Telephone | 2037777411 |
| Practice Fax Number | 2034012042 |
| Mailing Telephone | 2034320076 |
| Mailing Fax Number | 2034327289 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 000673 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS | 290000673CT03 | 01 |
| CT | OXFORD | P2685637 | 01 |
| CT | RAILROAD MEDICARE | 970025160 | 01 |
| CT | HEALTHNET | 0V8014 | 01 |
| CT | CONNECTICARE | 673000I420 | 01 |
| Street Address |
374 GRAND AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06513-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770582884 | Mary D Moller | Clinical Nurse Specialist | 374 Grand Ave, New Haven, CT 06513-3733 | 2005-07-20 |
| 1528669181 | Marisol Orth | Nurse Practitioner | 374 Grand Ave, New Haven, CT 06513-3733 | 2020-11-02 |
| 1851999874 | Ornella S Merino | Marriage & Family Therapist | 374 Grand Ave, New Haven, CT 06513-3733 | 2020-10-12 |
| 1043855521 | Joel Daniel Newman Bluman | Family Medicine | 374 Grand Ave, New Haven, CT 06513-3733 | 2019-11-08 |
| 1790215093 | Brian Padilla | Psychologist | 374 Grand Ave, New Haven, CT 06513-3733 | 2017-06-19 |
| 1346792355 | Quest Diagnostics LLC | Clinical Medical Laboratory | 374 Grand Ave, First Floor, New Haven, CT 06511 | 2016-10-26 |
| 1083078695 | Kyle Elligers | Family Medicine | 374 Grand Ave, New Haven, CT 06513-3733 | 2016-04-09 |
| 1073970224 | Kelly Elizabeth Gaffney | Dietitian, Registered | 374 Grand Ave, New Haven, CT 06513-3733 | 2016-01-19 |
| 1811353634 | Lori Goeschel | Dietitian, Registered | 374 Grand Ave, New Haven, CT 06513-3733 | 2016-01-08 |
| 1720468317 | Sandra Gisela Williams | Student in an Organized Health Care Education/Training Program | 374 Grand Ave, Fair Haven Clinic, New Haven, CT 06513-3733 | 2015-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366906141 | Edward Rivera | Case Manager/Care Coordinator | 458 Grand Ave., Suite 103, New Haven, CT 06513 | 2019-01-25 |
| 1134698442 | Village of Angels Home Health Care LLC | Respite Care | 470 James Street, Suite 007, New Haven, CT 06513 | 2018-11-15 |
| 1609358068 | Sarah Khalil | Pharmacist | 745 Foxon Road, East Haven, CT 06513 | 2018-09-02 |
| 1912358375 | Domanice Poindexter | Nurse Practitioner | Caremore Health, 444 Foxon Rd, East Haven, CT 06513 | 2016-06-28 |
| 1568839876 | My Fair Haven Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Grand Ave, New Haven, CT 06513 | 2015-08-24 |
| 1871979567 | Sankofa Counseling LLC | Community/Behavioral Health | 64 Thompson St Ste A101, East Haven, CT 06513 | 2015-08-04 |
| 1578967287 | Curtis Stewart | Pharmacy Technician | 661 Thompson Street, East Haven, CT 06513 | 2014-10-09 |
| 1548686322 | Davis Group LLC | Social Worker | 30 Grand Ave, New Haven, CT 06513 | 2014-03-17 |
| 1124459615 | James Lucas IIi | Dietitian, Registered | 167 Old Foxon Road, Unit 30b, New Haven, CT 06513 | 2013-12-09 |
| 1609206135 | Spretha Kadavath | Dentist | 50 Grand Ave, New Haven, CT 06513 | 2013-11-19 |
| Find all providers in zip 06513 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170546 | Kanwon Garley | Physician Assistant | 371 Alden Ave Apt 12b, New Haven, CT 06515-2146 | 2020-07-06 |
| 1366097271 | Lana Monashkin | Physician Assistant | 939 State St Apt C, New Haven, CT 06511-7318 | 2019-08-07 |
| 1013479898 | Andrea Ferraro | Physician Assistant | 35 Park St Rm 209, New Haven, CT 06519-1110 | 2019-04-02 |
| 1255875035 | Sarah Geanne Coffin | Physician Assistant | 51 Perkins St, New Haven, CT 06513-3210 | 2016-12-13 |
| 1790146066 | Philip Logan | Physician Assistant | 112 Dwight St Apt 29, New Haven, CT 06511-4532 | 2016-03-15 |
| 1962872523 | Diana G Poulsen | Physician Assistant | Yale New Haven Pediatric Ed, 1 Park St, New Haven, CT 06504 | 2015-09-25 |
| 1992192827 | Theodora Fraser Mcpherson | Physician Assistant | 151 Clifton St, New Haven, CT 06513-3319 | 2015-04-17 |
| 1851658561 | Tara Cotton | Physician Assistant | 20 York St Spc 2213, Mdrad Diagnostic Radiology, New Haven, CT 06510-3220 | 2012-04-19 |
| 1508147745 | Molly E Band | Physician Assistant | 1 Park St Fl 2, New Haven, CT 06504-8901 | 2011-09-01 |
| 1114243482 | Megan Elizabeth Dieterich | Physician Assistant | 175 W Park Ave, New Haven, CT 06511-2928 | 2010-04-12 |
| Find all providers in NEW HAVEN | ||||
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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.