JENNA KAITLYN CORDEIRO (NPI# 1407463235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407463235 |
| Entity Type | Individual |
| Full Name | JENNA KAITLYN CORDEIRO |
| Credential | PA-C |
| Practice Address |
428 Columbus Ave New Haven CT 06519-1233 |
| Mailing Address |
32 Hog Hill Rd East Hampton CT 06424-1821 |
| Practice Telephone | 2035033000 |
| Mailing Telephone | 8606820851 |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4968 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
428 COLUMBUS AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519-1233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932189370 | Catherine Hobbs Sharafanowich | Pharmacist | 428 Columbus Ave, Pharmacy Dept, New Haven, CT 06519-1233 | 2006-01-20 |
| 1588271605 | Bria Fernandes | Social Worker | 428 Columbus Ave, New Haven, CT 06519-1233 | 2020-09-24 |
| 1225654056 | Elizabeth Talbot | Student in an Organized Health Care Education/Training Program | 428 Columbus Ave, New Haven, CT 06519-1233 | 2020-06-17 |
| 1013559624 | Rocca L Perruccio | Nurse Practitioner | 428 Columbus Ave, New Haven, CT 06519-1233 | 2019-10-15 |
| 1831753045 | Anna Graham | Registered Nurse | 428 Columbus Ave, New Haven, CT 06519-1233 | 2019-04-24 |
| 1891258505 | Jennifer Hodio | Nurse Practitioner | 428 Columbus Ave, New Haven, CT 06519-1233 | 2019-04-09 |
| 1255815247 | Alicia M Dias | Nurse Practitioner | 428 Columbus Ave, New Haven, CT 06519-1233 | 2018-09-17 |
| 1275050056 | Zhuoshu Deng | Nurse Practitioner | 428 Columbus Ave, New Haven, CT 06519-1233 | 2017-08-23 |
| 1437694726 | Samantha N Nesbeth | Nurse Practitioner | 428 Columbus Ave, Internal Medicine, New Haven, CT 06519 | 2016-12-22 |
| 1437691888 | Robert George | Pharmacist | 428 Columbus Ave, New Haven, CT 06519-1233 | 2016-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
| Find all providers in zip 06519 | ||||
| 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 |
|---|---|---|---|---|
| 1477170546 | Kanwon Garley | Physician Assistant | 371 Alden Ave Apt 12b, New Haven, CT 06515-2146 | 2020-07-06 |
| 1366097271 | Lana Monashkin | Physician Assistant | 939 State St Apt C, New Haven, CT 06511-7318 | 2019-08-07 |
| 1013479898 | Andrea Ferraro | Physician Assistant | 35 Park St Rm 209, New Haven, CT 06519-1110 | 2019-04-02 |
| 1255875035 | Sarah Geanne Coffin | Physician Assistant | 51 Perkins St, New Haven, CT 06513-3210 | 2016-12-13 |
| 1790146066 | Philip Logan | Physician Assistant | 112 Dwight St Apt 29, New Haven, CT 06511-4532 | 2016-03-15 |
| 1962872523 | Diana G Poulsen | Physician Assistant | Yale New Haven Pediatric Ed, 1 Park St, New Haven, CT 06504 | 2015-09-25 |
| 1992192827 | Theodora Fraser Mcpherson | Physician Assistant | 151 Clifton St, New Haven, CT 06513-3319 | 2015-04-17 |
| 1851658561 | Tara Cotton | Physician Assistant | 20 York St Spc 2213, Mdrad Diagnostic Radiology, New Haven, CT 06510-3220 | 2012-04-19 |
| 1508147745 | Molly E Band | Physician Assistant | 1 Park St Fl 2, New Haven, CT 06504-8901 | 2011-09-01 |
| 1114243482 | Megan Elizabeth Dieterich | Physician Assistant | 175 W Park Ave, New Haven, CT 06511-2928 | 2010-04-12 |
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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.