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NPI Code Detail

MEDICARE: MS. TRISHNA WALSH

MEDICARE: MS. TRISHNA WALSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant001747CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669420584
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRISHNA WALSH
Provider Business Mailing Address
First Line : 385 MAIN ST S
Second Line : SUITE 301
City : SOUTHBURY
State : CT
Zip : 06488-4240
Country : US
Telephone Number : 203-264-3319
Fax Number : 203-267-6382
Provider Business Practice Location Address
First Line : 385 MAIN ST S
Second Line : SUITE 301
City : SOUTHBURY
State : CT
Zip : 06488-4240
Country : US
Telephone Number : 203-264-3319
Fax Number : 203-267-6382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 11/10/2021

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