Healthcare Provider Details

I. General information

NPI: 1447884978
Provider Name (Legal Business Name): RACHEL ELLEN LONDON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ELLEN SILVESTER PA-C

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-2212
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-2212
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-4450
  • Fax:
Mailing address:
  • Phone: 860-679-4450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4756
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: