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NPI Code Detail

MEDICARE: MRS. LOIS-ANN CERISE LOVELACE RPA-C

MEDICARE: MRS. LOIS-ANN CERISE LOVELACE RPA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant011248NY
2363AM0700XMedical Physician Assistant5034CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710926696
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LOIS-ANN CERISE LOVELACE RPA-C
Provider Business Mailing Address
First Line : 1290 SILAS DEANE HWY
Second Line : HARTFORD HEALTHCARE-CVO
City : WETHERSFIELD
State : CT
Zip : 06109-4337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 385 W MAIN ST
Second Line :
City : AVON
State : CT
Zip : 06001-4357
Country : US
Telephone Number : 860-777-1280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 04/15/2022

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Directions to “ MRS. LOIS-ANN CERISE LOVELACE RPA-C” Practice Location

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