Healthcare Provider Details

I. General information

NPI: 1669420584
Provider Name (Legal Business Name): TRISHNA WALSH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

85 SEYMOUR ST STE 125B
HARTFORD CT
06106-5501
US

V. Phone/Fax

Practice location:
  • Phone: 860-962-7022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001747
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: