HEATHER TETTELBACH (NPI# 1649819731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649819731 |
| Entity Type | Individual |
| Full Name | HEATHER TETTELBACH |
| Practice Address |
85 Seymour St Ste 1003 Hartford CT 06106-5529 |
| Mailing Address |
85 Seymour St Ste 1022 Hartford CT 06106-5530 |
| Practice Telephone | 8606962290 |
| Mailing Telephone | 2032008187 |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 4682 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
4682 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Hazard Ave Ste 101, Enfield, CT 060825447 | 8606962380 |
| Street Address |
85 SEYMOUR ST STE 1003 |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| 1942798673 | Meghana Singh | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1134536311 | Allyson E Kubasek | Physician Assistant | 32 Seymour Street, Hartford Hospital Orthopedics Dept, Hartford, CT 06102-5037 | 2014-07-19 |
| 1063037091 | Andrew Jon Mccarthy | Physician Assistant | 80 Seymour St, Hartford, CT 06106-3315 | 2020-06-16 |
| 1417570722 | Leah Pawelczyk | Physician Assistant | 80 Seymour St, Hartford, CT 06102-8000 | 2020-05-20 |
| 1164044947 | Marena Josephine Harrison | Physician Assistant | 114 Woodland St, Hartford, CT 06105-1208 | 2020-05-14 |
| 1528688132 | Tess B Repaci | Physician Assistant | 80 Seymour St, Hartford, CT 06106-3300 | 2020-04-23 |
| 1588283584 | Dana Wells Mcpherson | Physician Assistant | 80 Seymour Street, Hartford Hospital Surgery Dept, Hartford, CT 06102-8000 | 2020-04-10 |
| 1407486277 | Ashley Weisse | Physician Assistant | 80 Seymour St, Hartford, CT 06102-8000 | 2020-01-21 |
| 1053954222 | Nicole Ann Dietzel | Physician Assistant | 282 Washington St, Hartford, CT 06106-3322 | 2019-10-21 |
| 1952951121 | Lindsay Nicole Palma | Physician Assistant | 80 Seymour St, Hartford, CT 06102-8000 | 2019-09-18 |
| Find all providers in HARTFORD | ||||
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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.