Healthcare Provider Details

I. General information

NPI: 1427179563
Provider Name (Legal Business Name): THOMAS ROY GARRIGAN RN, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-4187
  • Fax: 860-545-2006
Mailing address:
  • Phone: 860-545-4187
  • Fax: 860-545-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number000377
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR33924
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: