Healthcare Provider Details

I. General information

NPI: 1548808074
Provider Name (Legal Business Name): RACHEL CRISTINA JOAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL CRISTINA LITCHFIELD

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 DALE RD STE 204
AVON CT
06001-4351
US

IV. Provider business mailing address

30 JORDAN LN STE 2
WETHERSFIELD CT
06109-1278
US

V. Phone/Fax

Practice location:
  • Phone: 860-674-8830
  • Fax: 860-674-8984
Mailing address:
  • Phone: 860-263-0253
  • Fax: 860-263-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5186
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: