AIMEE J CRISCUOLO BECK (NPI# 1124122650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124122650 |
| Entity Type | Individual |
| Full Name | AIMEE J CRISCUOLO BECK |
| Other Name | AIMEE CRISCUOLO |
| Credential | P.A. |
| Practice Address |
481 Gold Star Hwy Ste 100 Groton CT 06340-6702 |
| Mailing Address |
420 Saybrook Rd Middletown CT 06457-4747 |
| Practice Telephone | 8604468858 |
| Practice Fax Number | 8604052140 |
| Mailing Telephone | 8606262010 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
000925 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BC/BS | 290000925CT01 | 01 |
| CT | CONNECTICARE | 000925 | 01 |
| Street Address |
481 GOLD STAR HWY STE 100 |
| City | GROTON |
| State | CT |
| Zip Code | 06340-6702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528432416 | Michael Tansey | Physician Assistant | 22 Partridge Rd, 22 Partridge Rd, Groton, CT 06340-4323 | 2015-11-16 |
| 1437253655 | David J Mccormick | Physician Assistant | 220 Route 12, Groton, CT 06340-3414 | 2006-09-08 |
| 1659713683 | Katelyn Doran Jupin | Physician Assistant | 220 Route 12, Groton, CT 06340-3414 | 2013-07-18 |
| 1396186631 | Zachary J. Jupin | Physician Assistant | 220 Route 12, Groton, CT 06340-3414 | 2013-07-16 |
| 1063700078 | Ryan Elaine Bolton | Physician Assistant | 75 Eastern Point Rd, Station A78, Groton, CT 06340-4905 | 2011-07-12 |
| 1578693917 | Ahmad M. Mehdi M.d P.c | Physician Assistant | 100 Sykes St, Groton, NY 13073-1231 | 2007-03-06 |
| 1801840095 | Mark Duston Schulthess | Physician Assistant | Route 12 Bldg 449, Naval Ambulatory Care Center Attn Professional Affairs, Groton, CT 06349-5600 | 2006-05-20 |
| 1770545360 | David B Berlin | Physician Assistant | 1 Wahoo Ave, Groton, CT 06349-2324 | 2006-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163671 | Kirsten Alexandra Drobiak | Physician Assistant | 37 Jennifer Ln, Griswold, CT 06351-3500 | 2020-10-28 |
| 1255955019 | Amanda Uscilla | Physician Assistant | 20 Hilltop Rd, Bethany, CT 06524-3514 | 2020-06-07 |
| 1689208571 | Sage Ann Miele | Physician Assistant | 149 Water St Apt 32, Norwalk, CT 06854-3758 | 2020-02-28 |
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1811547508 | Gabriela M Vargas | Physician Assistant | 24 Hospital Ave # Tower7, Danbury, CT 06810-6099 | 2019-09-16 |
| 1275192049 | Molly J Mable | Physician Assistant | 282 Washington St Fl 1, Hartford, CT 06106-3322 | 2019-06-06 |
| 1003377631 | Stephan Anton Bayer | Physician Assistant | 205 Elm St Apt 5, West Haven, CT 06516-4659 | 2019-03-27 |
| 1578024105 | Vance P Baughman | Physician Assistant | 325 Lafayette St Unit 1003, Bridgeport, CT 06604-5472 | 2019-03-27 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
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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.