KYLIE TANABE (NPI# 1417324344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417324344 |
| Entity Type | Individual |
| Full Name | KYLIE TANABE |
| Credential | PA-C |
| Practice Address |
40 Prospect Ave Building 2, 4c Norwalk CT 06850-3737 |
| Mailing Address |
24 Stevens St Building 2, 4c Norwalk CT 06850-3852 |
| Practice Telephone | 2076710235 |
| Mailing Telephone | 2038522188 |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2017-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 3407 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
54130 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3407 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
40 PROSPECT AVE BUILDING 2, 4C |
| City | NORWALK |
| State | CT |
| Zip Code | 06850-3737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477735181 | Timothy Compton Stewart | Physician Assistant | 40 Prospect Ave, Bldg. 2, Apt. #3h, Norwalk, CT 06850-3737 | 2007-12-04 |
| 1821535170 | Flushot LLC | Preventive Medicine | 40 Prospect Ave, Building 2-2f, Norwalk, CT 06850-3737 | 2017-01-25 |
| 1518310333 | Gaston Jeremiah | Physician Assistant | 40 Prospect Ave, Building 2 - Apartment 4a, Norwalk, CT 06850-3737 | 2016-07-16 |
| 1538325303 | Norwalk Hospital | General Acute Care Hospital | 40 Prospect Ave, Building # 2, Apt # 2 E, Norwalk, CT 06850-3737 | 2008-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497105092 | Brightview Norwalk, LLC | Alzheimer Center (Dementia Center) | 162 New Canaan Ave., Norwalk, CT 06850 | 2016-06-15 |
| 1518321306 | Megan Yee | Social Worker | 54 W. Norwalk Road, Norwalk, CT 06850 | 2016-04-08 |
| 1992129886 | Alicia Collen Zeidan | Nurse Practitioner | 10 Mott Ave Ste 2a, Norwalk, CT 06850 | 2014-02-12 |
| 1306194642 | Diane Beth Weiss | Specialist | 12 Rae Lane, Norwalk, CT 06850 | 2012-08-16 |
| 1538491170 | Thomas C. Santaniello | Dentist | 16 River Street, Norwalk, CT 06850 | 2010-02-08 |
| 1720226988 | Kathleen F Dayton | Counselor | 4 Berkeley Street, Super Kids, Norwalk, CT 06850 | 2009-01-27 |
| 1578716783 | Helen B. Mccue | Social Worker | 9 Mott Avenue, Family and Children's Agency, Norwalk, CT 06850 | 2008-10-31 |
| 1609900497 | James Schumacher | Physician Assistant | Maple Avenue, Norwalk, CT 06850 | 2007-03-15 |
| 1134270002 | Neelam Narula | Nurse Practitioner | 34 Maple St Ste J, Norwalk, CT 06850 | 2007-01-16 |
| 1669559951 | Patricia Jorquera | Pediatrics | 10 Mott Avenue, 4th Floor, Norwalk, CT 06850 | 2006-11-01 |
| Find all providers in zip 06850 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798362 | Brandon H Kusako | Physician Assistant | 34 Maple St Dept Of, Norwalk, CT 06850-3815 | 2020-10-26 |
| 1962920561 | Eugenie Cho | Physician Assistant | 34 Maple St., Norwalk, CT 06856 | 2017-09-03 |
| 1902238207 | Katherine Anne Swan | Physician Assistant | 148 East Ave Ste 3d, Norwalk, CT 06851-5733 | 2013-08-08 |
| 1407186190 | Damien M Chicarilli | Physician Assistant | 23 Richmond Hill Rd, Norwalk, CT 06854-2515 | 2010-01-04 |
| 1477735181 | Timothy Compton Stewart | Physician Assistant | 40 Prospect Ave, Bldg. 2, Apt. #3h, Norwalk, CT 06850-3737 | 2007-12-04 |
| 1609900497 | James Schumacher | Physician Assistant | Maple Avenue, Norwalk, CT 06850 | 2007-03-15 |
| 1245294198 | Becky D Mcandrews | Physician Assistant | 30 Stevens St, Suite D, Norwalk, CT 06850-3859 | 2006-04-15 |
| 1235740960 | Taylor Lin Nedurian | Physician Assistant | 34 Maple St, Norwalk, CT 06850-3894 | 2020-08-14 |
| 1710596754 | Lauren Matla | Physician Assistant | 34 Maple St, Norwalk, CT 06850-3894 | 2020-07-27 |
| 1417575457 | Anne Patricia Murphy | Physician Assistant | 34 Maple St, Norwalk, CT 06850-3894 | 2020-07-07 |
| Find all providers in NORWALK | ||||
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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.