Healthcare Provider Details

I. General information

NPI: 1639530207
Provider Name (Legal Business Name): LISA HEDGEPATH SILVESTRINI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA ANN HEDGEPATH CRNA

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BOSTON POST RD
GUILFORD CT
06437-2747
US

IV. Provider business mailing address

333 CEDAR ST # ST3
NEW HAVEN CT
06510-3206
US

V. Phone/Fax

Practice location:
  • Phone: 203-453-7100
  • Fax:
Mailing address:
  • Phone: 203-785-2802
  • Fax: 203-785-6664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN229155
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7008
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: