Healthcare Provider Details

I. General information

NPI: 1578834875
Provider Name (Legal Business Name): CATRINA RAE SHUBERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATRINA BURGSTAHLER

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND ST
NEW BRITAIN CT
06052-2016
US

IV. Provider business mailing address

100 GRAND ST
NEW BRITAIN CT
06052-2016
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5011
  • Fax:
Mailing address:
  • Phone: 860-224-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number002690
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: