MIRANDA POLASKI (NPI# 1003307554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003307554 |
| Entity Type | Individual |
| Full Name | MIRANDA POLASKI |
| Credential | PA |
| Practice Address |
81 Meriden Ave Southington CT 06489 |
| Mailing Address |
81 Meriden Ave Southington CT 06489-3268 |
| Practice Telephone | 8602765000 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4140 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
81 MERIDEN AVE |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376594416 | Samuel Lewis Siegler | Emergency Medicine | 81 Meriden Ave, Southington, CT 06489-3268 | 2006-05-13 |
| 1134679764 | Ramzia Julia Asheh | Physician Assistant | 81 Meriden Ave, Emergency Department, Southington, CT 06489-3268 | 2016-10-06 |
| 1265985964 | Morgan Mcdermott | Nurse Practitioner | 81 Meriden Ave, Southington, CT 06489-3268 | 2016-07-28 |
| 1528479664 | Hhc Southington Surgery Center, LLC | Clinic/Center | 81 Meriden Ave, Southington, CT 06489-3268 | 2014-05-12 |
| 1235482514 | Michael Colella | Nurse Anesthetist, Certified Registered | 81 Meriden Ave, Southington, CT 06489-3268 | 2012-10-24 |
| 1144598798 | Lisa Naidoo | Nurse Anesthetist, Certified Registered | 81 Meriden Ave, Southington, CT 06489-3268 | 2011-12-12 |
| 1952535825 | Lisa Desiderio Consiglio | Nurse Practitioner | 81 Meriden Ave, Southington, CT 06489-3268 | 2009-05-07 |
| 1558468611 | John Francis Scarfo | Emergency Medicine | 81 Meriden Ave, Southington, CT 06489-3268 | 2006-09-20 |
| 1679677306 | Mandell & Blau, Md's PC | Radiology | 81 Meriden Ave, Southington, CT 06489-3268 | 2006-09-12 |
| 1851402457 | Rachel Mello Iv | Nurse Anesthetist, Certified Registered | 81 Meriden Ave, Southington, CT 06489-3268 | 2006-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087783 | Shankar Panwar | Counselor | K 11, 1783 Meriden Waterbury Tpke, Southington, CT 06489 | 2020-03-06 |
| 1235771056 | Kathleen Rebecca Mckinney | Music Therapist | 196 Queen St., Southington, CT 06489 | 2019-10-14 |
| 1336700103 | Julie Amanda Nichols | Behavioral Analyst | 1842 Meriden-waterbury Turnpike, Southington, CT 06489 | 2019-06-24 |
| 1396238960 | Kriston Ronalter | Physician Assistant | 775 Queen Street, Southington, CT 06489 | 2018-06-08 |
| 1366933582 | Cj's Counseling, LLC | Counselor | 17 Meriden Ave Ste 1a, Southington, CT 06489 | 2018-05-23 |
| 1104329887 | Koby Douglas Fowler | Chiropractor | 1095 West St Unit 1, Southington, CT 06489 | 2018-03-09 |
| 1447763131 | Samreen, LLC | Clinic/Center | 775 Queen St, Suite 2, Southington, CT 06489 | 2017-11-16 |
| 1902320724 | Michael Petit | Physical Therapist | 98 Main Street, 202, Southington, CT 06489 | 2017-08-02 |
| 1457712127 | Leslie Mclaughlin | Speech-Language Pathologist | 400 Flanders Rd, Southington, CT 06489 | 2016-03-09 |
| 1306219159 | Breanne Schnepf-hanbury | Counselor | 26 N Main St Ste 2b, Southington, CT 06489 | 2015-11-02 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144873225 | Emily Amanda Durocher | Physician Assistant | 98 Main St Ste 203, Southington, CT 06489-2500 | 2019-07-18 |
| 1770868408 | Kawal Hanjan-fusco | Physician Assistant | 110 Dunham Pl, Hartford Hospital Emergency Room, Southington, CT 06489-1201 | 2011-10-13 |
| 1730287350 | Kevin Thomas Mccrystal | Physician Assistant | 81 Menden Avenue, Bradley Memorial Hospital, Southington, CT 06489 | 2006-09-20 |
| 1700872694 | Allison L Valley | Physician Assistant | 775 W Queen Street, Southington, CT 06489 | 2005-09-26 |
| 1134679764 | Ramzia Julia Asheh | Physician Assistant | 81 Meriden Ave, Emergency Department, Southington, CT 06489-3268 | 2016-10-06 |
| 1710107230 | Carol L Rizzolo | Physician Assistant | 340 N Main St, Southington, CT 06489-2529 | 2007-04-26 |
| 1053535245 | Rebecca Davies Jeffery | Physician Assistant | 340 N Main St, Southington, CT 06489-2529 | 2007-04-12 |
| 1548271463 | Michael Anthony Sposato | Physician Assistant | 98 Main St, Midstate Medical Group, Southington, CT 06489-2500 | 2006-08-10 |
| 1396715629 | Frank J Zimmitti | Physician Assistant | 360 N Main St, Southington, CT 06489-2503 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295913 | Courtney Marquardt | Physician Assistant | 25 Buckland Rd, South Windsor, CT 06074-3703 | 2020-11-04 |
| 1154922623 | Alexis Cardinali | Physician Assistant | 175 S Meriden Rd, Cheshire, CT 06410-2973 | 2020-11-02 |
| 1689274417 | Danielle Kerr | Physician Assistant | 1055 Kennedy Rd, Windsor, CT 06095-1308 | 2020-10-30 |
| 1467051920 | Cynthia G Moreno | Physician Assistant | 76 Newtown Rd Ste C, Danbury, CT 06810-6265 | 2020-10-25 |
| 1245837764 | Lauren Tripodi | Physician Assistant | 9 Sunset Hill Rd, Newtown, CT 06470-1318 | 2020-10-07 |
| 1710594403 | Mary Josephine Elliott | Physician Assistant | 50 Beechwood Dr, Madison, CT 06443-1847 | 2020-09-26 |
| 1558977868 | Gabrielle Guetta | Physician Assistant | 25 Woody Ln, Westport, CT 06880-2260 | 2020-09-22 |
| 1609481639 | Gresi Kello | Physician Assistant | 506 Frost Rd, Waterbury, CT 06705-2304 | 2020-09-15 |
| 1477167351 | Connecticut Children's Eye Care, P.C. | Physician Assistant | 131 New London Tpke Ste 200, Glastonbury, CT 06033-2246 | 2020-09-08 |
| 1750991303 | Lana Chapman | Physician Assistant | 289 Curtis St Apt 2, Meriden, CT 06450-5910 | 2020-08-07 |
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| City | SOUTHINGTON |
| Zip Code | 06489 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.