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General NPI Number Information
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NPI Number | 1174362180
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Entity Type | Individual
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Provider Name | AMBER SOUSA PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 80 SEYMOUR ST
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City | HARTFORD
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State | CT
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Zip | 06102-8000
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Country | US
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Telephone | 860-972-2795
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Fax | 860-545-3134
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HWY HHC-CVO
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4337
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Country | US
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Telephone | 860-972-5507
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Fax | 860-972-7040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006594
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License Number State | CT
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