LAURA MARIE GRILLO (NPI# 1548681026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548681026 |
| Entity Type | Individual |
| Full Name | LAURA MARIE GRILLO |
| Credential | PA-C |
| Practice Address |
263 Farmington Avenue Farmington CT 06030-8083 |
| Mailing Address |
263 Farmington Avenue Farmington CT 06030-8082 |
| Practice Telephone | 8606798080 |
| Practice Fax Number | 8606791340 |
| Mailing Telephone | 8606798080 |
| Mailing Fax Number | 8606791340 |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2020-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 003042 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
003042 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
003042 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 003030426 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 80 Seymour St, Hartford Hospital Surgery Dept, Hartford, CT 061028000 | 8609724670 | |
| 1 Royce Circle, Storrs, CT 062687003 | 8606798080 | 8606791340 |
| 117 Albany Turnpike, Canton, CT 060197180 | 8606798080 | 8606791340 |
| Street Address |
263 FARMINGTON AVENUE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-8083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669466561 | State of Connecticut | Clinic/Center | 263 Farmington Avenue, Farmington, CT 06030-5355 | 2005-09-07 |
| 1619584026 | Sylvia Polanco | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030-8203 | 2020-09-29 |
| 1154930956 | Lindsay Allison Petriello | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030 | 2020-07-28 |
| 1891304663 | Kara Dazkevich | Nurse Practitioner | 263 Farmington Avenue, Farmington, CT 06030-0001 | 2020-07-28 |
| 1093324873 | Kaitlin Jeanne O'connor | Nurse Practitioner | 263 Farmington Avenue, Icu, University Tower, 1st Floor, Mail Code: 1131, Farmington, CT 06030 | 2020-07-28 |
| 1457975070 | Shriya Gupta | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Uconn Health - Outpatient Pavilion, Farmington, CT 06030-8031 | 2020-05-29 |
| 1114540150 | Carolina Mendes Pessoa | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, 2 West Uconn Clinic, Internal Medicine Associates, Ou, Farmington, CT 06032 | 2020-05-26 |
| 1457971293 | Christopher Dalton Lemoine | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-8073 | 2020-04-22 |
| 1871112953 | Cory Hewitt | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-4037 | 2020-04-09 |
| 1154940310 | Jeffrey Henry | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue, Farmington, CT 06030-1930 | 2020-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617606 | David Wozny | Student in an Organized Health Care Education/Training Program | General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-13 |
| 1508495185 | Zachary Boivin | Student in an Organized Health Care Education/Training Program | Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-06 |
| 1063903730 | Agura Afiari | Student in an Organized Health Care Education/Training Program | Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 | 2018-05-29 |
| 1750879474 | Areeba Siddiqui | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue Mc1921, Farmington, CT 06030 | 2018-04-27 |
| 1508362013 | Arya Saniee I | Student in an Organized Health Care Education/Training Program | 264 Farmington Ave, Farmington, CT 06030 | 2018-04-03 |
| 1679828594 | Randall Morera | Student in an Organized Health Care Education/Training Program | 262 Farmington Ave, Farmington, CT 06030 | 2012-07-17 |
| 1750644365 | Ugonna Ijeoma | Student in an Organized Health Care Education/Training Program | 260 Farmington Ave, Farmington, CT 06030 | 2012-06-19 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1851456495 | Jeffrey Gross | Anesthesiology | 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 | 2006-12-26 |
| 1649225269 | Julian Nieves | Internal Medicine | 263 Famrington Avenue, Farmington, CT 06030 | 2006-05-23 |
| Find all providers in zip 06030 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295845592 | George Juraj Sertic | Physician Assistant | 23843 Colchester St, Farmington, MI 48336-2415 | 2006-08-30 |
| 1023460789 | Alexandra Shaw | Physician Assistant | Uconn Medical Group, 263 Farmington Ave, Farmington, CT 06030-0001 | 2016-07-06 |
| 1891150108 | Erica Lankenau | Physician Assistant | 630 W Maple St, Farmington, NM 87401-6113 | 2015-12-31 |
| 1225446842 | Abigail Guy | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-0001 | 2014-07-28 |
| 1093075038 | Sreelakshmi Reddivari | Physician Assistant | 263 Farmington Ave, General Surgery, Farmington, CT 06030-6227 | 2012-05-24 |
| 1922310135 | Ashley Nicole French | Physician Assistant | 263 Farmington Ave, General Surgery, Farmington, CT 06030-6227 | 2010-07-06 |
| 1083948574 | Karin M Koval | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-6227 | 2009-09-30 |
| 1205067519 | Isaac S Ball | Physician Assistant | 126 Middle St, Farmington, ME 04938-6937 | 2009-08-04 |
| 1811161938 | Mary Ellen Cerroni | Physician Assistant | 801 W Maple St, Farmington, NM 87401-5630 | 2008-04-18 |
| 1316003908 | Samuel W. Gaston | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-0001 | 2006-12-28 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 06030 |
Please comment or provide details below to improve the information on LAURA MARIE GRILLO.
| 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.