Healthcare Provider Details

I. General information

NPI: 1194823575
Provider Name (Legal Business Name): JOAN L RISHEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN LIANE NOTGHI PA-C

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 N MAIN ST STE 350
WEST HARTFORD CT
06117-2500
US

IV. Provider business mailing address

30 JORDAN LN
WETHERSFIELD CT
06109-1278
US

V. Phone/Fax

Practice location:
  • Phone: 860-296-4022
  • Fax: 860-772-0095
Mailing address:
  • Phone: 860-263-0253
  • Fax: 860-263-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number000552
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0606
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: