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General NPI Number Information
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NPI Number | 1710339908
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Entity Type | Individual
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Provider Name | PAUL HERLAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 333 CEDAR ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 203-785-2660
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Fax | 203-785-3404
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Provider Business Mailing Address
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Address Line | 333 CEDAR ST PO BOX 208005
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City | NEW HAVEN
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State | CT
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Zip | 06520-8005
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Country | US
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Telephone | 203-785-2660
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Fax | 203-785-3404
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9109524
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | CT0641
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License Number State | CT
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