person
Lisa Marie Tanguay, PA
Surgical Physician Assistant in Waterbury, Connecticut
NPI 1659307916

Lisa Marie Tanguay is a Surgical Physician Assistant based in Waterbury, CT and is specialized in Surgical. Lisa Marie Tanguay practices in Waterbury, CT and has the professional credentials of PA. The NPI Number for Lisa Marie Tanguay is 1659307916 and holds a License No. 000863 (Connecticut).

The current practice location address for Lisa Marie Tanguay is 56 Franklin St, Waterbury, CT and can be reached out via phone at 203-709-6314 and via fax at 203-709-6089. You can also correspond with Lisa Marie Tanguay through the mailing address at 56 FRANKLIN ST, WATERBURY, CT - 06706-1221 (mailing address contact number: 203-709-8873).

Location: 56 Franklin St, Waterbury, CT, 06706-1221
person
Provider Profile Details
NPI Number
1659307916
Provider Name
Lisa Marie Tanguay
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
56 Franklin St, Waterbury, CT, 06706-1221
Phone Number
203-709-6314
Fax Number
203-709-6089
Provider Enumeration Date
06/25/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
061470493 01 CT COVENTRY/FIRST HEALTH
080863 01 CT CONNECTICARE
290000863CT11 01 CT ANTHEM BCBS CT
2V1632 01 CT HEALTHNET/COMMERCIAL
008010398 05 CT
208796 01 CT WELLCARE
22-59899 01 CT AMERICHOICE
877800 01 CT USA
9886225 01 CT AETNA
P3134207 01 CT OXFORD
institution
Provider Business Practice Location Address Details
Address
56 Franklin St
City
State
Zip
06706-1221
Phone Number
203-709-6314
Fax Number
203-709-6089
person
Provider Business Mailing Address Details
Address
56 Franklin St
City
State
Zip
06706-1221
Phone Number
203-709-6314
Fax Number
203-709-6089
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
000863 (Connecticut)
Definition
Definition to come...
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