Jacquelyne Phanavong
Physician Assistant in New Britain, Connecticut
1730439597- Practice location
- 100 Grand St, New Britain, CT 06052-2016
- Phone
- 860-224-5675
- Fax
- 860-224-5774
- Last updated
- February 15, 2017
Jacquelyne Phanavong is a Physician Assistant based in New Britain, CT. Jacquelyne Phanavong practices in New Britain, CT. The NPI Number for Jacquelyne Phanavong is 1730439597 and holds a License No. 02813 (CT). The current practice location address for Jacquelyne Phanavong is 100 Grand St, New Britain, CT 06052-2016 and can be reached out via phone at 860-224-5675 and via fax at 860-224-5774.
Provider Profile Details
- NPI Number
- 1730439597
- Provider Name
- Jacquelyne Phanavong
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 100 Grand St, New Britain, CT 06052-2016
- Phone Number
- 860-224-5675
- Fax Number
- 860-224-5774
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 19, 2012
- Last Update Date
- February 15, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 100 Grand St
New Britain, CT 06052-2016 - City
- New Britain
- State
- Connecticut
- Zip
- 06052-2016
- Phone Number
- 860-224-5675
- Fax Number
- 860-224-5774
Provider Business Mailing Address Details
- Address
- 100 Grand St
New Britain, CT 06052-2016 - City
- New Britain
- State
- CT
- Zip
- 06052-2016
- Phone Number
- 860-224-5675
- Fax Number
- 860-224-5774
License Information
- License Number
- 02813
- License State
- CT
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jacquelyne Phanavong?
The NPI number of Jacquelyne Phanavong is 1730439597. It was assigned on September 19, 2012 and is currently active in the NPPES registry.
What is the specialty of Jacquelyne Phanavong?
Jacquelyne Phanavong is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in CT under license number 02813.
Where does Jacquelyne Phanavong practice?
The practice location is 100 Grand St, New Britain, CT 06052-2016. The office can be reached at 860-224-5675 (phone) or 860-224-5774 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1730439597 directly on the NPPES registry website.