MS. AMANDA NICOLE REA (NPI# 1710418017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710418017 |
| Entity Type | Individual |
| Full Name | MS. AMANDA NICOLE REA |
| Credential | PA-C |
| Practice Address |
130 Division St Derby CT 06418-1326 |
| Mailing Address |
195 Broadmere Rd Stratford CT 06614-2506 |
| Practice Telephone | 2037357222 |
| Mailing Telephone | (203) 809-9871 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3849 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 126 Park Ave, Bridgeport, CT 066047620 | 2035762400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598111502 | Amanda Rea | Nurse Practitioner | 7601 Osler Dr, Towson, MD 21204-7700 | 2016-05-09 |
| Street Address |
130 DIVISION ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427058478 | Mihaela Boran | Psychiatry & Neurology | 130 Division St, Derby, CT 06418-1326 | 2005-07-29 |
| 1437767134 | Sovit Dahal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-07-20 |
| 1649894056 | Julie Sim | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-06-01 |
| 1073133435 | Angad Singh Gill | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2020-04-25 |
| 1699394924 | Ricardo Adolfo Concepcion Gomez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418 | 2020-04-16 |
| 1104455112 | Maharshi Panchal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-02 |
| 1104455252 | Anwesh Babu Poosala | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-01 |
| 1720615271 | Anthony Karam Awad | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-25 |
| 1134756760 | Douglas Misael Palacios Hernandez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
| 1437786142 | Rosa Constantino | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
| Find all providers in zip 06418 | ||||
| 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 |
|---|---|---|---|---|
| 1770025132 | Cayla Cirsten Daniele | Physician Assistant | 300 Seymour Ave Suite 102, Derby, CT 06418-1343 | 2016-11-16 |
| 1356704092 | Rock Road Emergency Physicians LLC | Physician Assistant | 63rd St S. Rock Road, Derby, KS 67227 | 2016-03-31 |
| 1649665936 | Jacqueline Braunworth | Physician Assistant | 68 Division St, Derby, CT 06418-1447 | 2015-04-02 |
| 1861600017 | Timothy L. Weide | Physician Assistant | 1121 N College Park St, Suite # 400, Derby, KS 67037-3665 | 2007-05-20 |
| 1750464160 | Betsy L Strack | Physician Assistant | 6763 Erie Rd, Derby, NY 14047-9670 | 2006-10-23 |
| 1619933389 | Leon M Garcia | Physician Assistant | 130 Derby Ave, Derby, CT 06418-2010 | 2006-04-21 |
| 1679562664 | Debra Sue Longbine | Physician Assistant | 6970 Erie Rd, Derby, NY 14047-9591 | 2005-10-21 |
| 1093200644 | Jana L Scripp | Physician Assistant | 1640 E Tall Tree Rd, Derby, KS 67037 | 2018-06-26 |
| 1194217570 | Brianna Marie Weber | Physician Assistant | 130 Division St, Derby, CT 06418-1326 | 2018-06-01 |
| 1205355385 | Codie Marie Armstead | Physician Assistant | 1824 E James St, Derby, KS 67037 | 2017-09-11 |
| Find all providers in DERBY | ||||
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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.