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General NPI Number Information
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NPI Number | 1427708940
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Entity Type | Individual
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Provider Name | ALLISON VANASSE
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Gender | Female
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Dates
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Enumeration Date | 03/27/2022
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 54 HAZARD AVE STE 135
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City | ENFIELD
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State | CT
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Zip | 06082-3885
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Country | US
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Telephone | 860-787-5780
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HWY HARTFORD HEALTHCARE-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 |
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 6019
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License Number State | CT
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