NPI 1295814119 · live from the CMS NPI Registry
Tara Beth Anderson, PA
Physician Assistant in New Haven, CT. National Provider Identifier 1295814119, active.
NPI record
| NPI | 1295814119 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 20 York St, New Haven, CT 06510 |
| Practice phone | 203-200-4737 |
| Mailing address | 30 Sandlewood Dr, Madison, CT 06443 |
| Enumerated | November 2, 2006 |
| Last updated | November 25, 2015 |
| Sole proprietor | No |
| Other names | Tara Kendall |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 5601003748 (MI) |
| Physician Assistant | 363A00000X | PA 00782 (RI) |
| Physician Assistant primary | 363A00000X | 003174 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.