NPI 1184956690 · live from the CMS NPI Registry
Diane Packard Annibalini, PA-C
Physician Assistant in Tolland, CT. National Provider Identifier 1184956690, active.
NPI record
| NPI | 1184956690 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 384 Merrow Rd Ste K, Tolland, CT 06084 |
| Practice phone | 860-871-8851 |
| Mailing address | O6 Saint Marc Cir, South Windsor, CT 06074 |
| Enumerated | February 8, 2010 |
| Last updated | March 17, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical | 363AM0700X | 002348 (CT) |
| Physician Assistant primary | 363A00000X | 2348 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.