MEDICARE: MRS. FARRAH CARRION PA-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
1	363A00000X	Physician Assistant	3061	TN
2	363A00000X	Physician Assistant	6096	CT

General Provider Information

NPI Number	:	1801340344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FARRAH CARRION PA-C

Provider Business Mailing Address
First Line	:	1290 SILAS DEANE HIGHWAY
Second Line	:	HHC - CVO
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-4337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 FARMINGTON AVENUE
Second Line	:	1ST FLOOR
City	:	FARMINGTON
State	:	CT
Zip	:	06032-1964
Country	:	US
Telephone Number	:	860-677-3950
Fax Number	:	860-724-4397

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2016
Last Update Date	:	08/04/2023

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