Healthcare Provider Details

I. General information

NPI: 1427972082
Provider Name (Legal Business Name): PROASSIST SPECIALITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 DANBURY RD
WILTON CT
06897-4486
US

IV. Provider business mailing address

15 PORTER FARM RD
EAST BRIDGEWATER MA
02333-1179
US

V. Phone/Fax

Practice location:
  • Phone: 475-257-6500
  • Fax:
Mailing address:
  • Phone: 774-222-3644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER LEAVITT
Title or Position: PHYSICIAN ASSISTANT
Credential: PA-C
Phone: 774-222-3644