DIANA SHAPOVAL (NPI# 1841810967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841810967 |
| Entity Type | Individual |
| Full Name | DIANA SHAPOVAL |
| Credential | PA |
| Practice Address |
56 Franklin St Waterbury CT 06706-1253 |
| Mailing Address |
30 Seminary St Bristol CT 06010-5520 |
| Practice Telephone | 2037096000 |
| Mailing Telephone | 9082297685 |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2020-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
56 FRANKLIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929379 | Scovill Medical Group, PC | Internal Medicine | 56 Franklin St, Waterbury, CT 06706-1221 | 2005-06-01 |
| 1528676459 | Kate Marie Breiner | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-16 |
| 1417575192 | Muhammad Tasawar Latif | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-09 |
| 1013534148 | Syed Mustajab Ahmed | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1558989681 | Brooj Awan | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1699398438 | Michelle Lauren Yeung | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-05-27 |
| 1235768649 | Sean Michael Burgwardt | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
| 1043849326 | Miguel Angel Bravo Jr. | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
| 1053948430 | Bhavya Vemuri | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-25 |
| 1538795455 | Yucel Aydin | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| 1962881896 | Daniyal Ahmed Ansari | Internal Medicine | 56 Franklin Street, Saint Mary's Hospital, Waterbury, CT 06706 | 2015-05-26 |
| 1164809885 | Vanessa N. Goyes Ruiz | Student in an Organized Health Care Education/Training Program | 56 Franklin Street, Waterbury, CT 06706 | 2015-05-01 |
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| 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 |
|---|---|---|---|---|
| 1609481639 | Gresi Kello | Physician Assistant | 506 Frost Rd, Waterbury, CT 06705-2304 | 2020-09-15 |
| 1801446554 | George Ahyia Osae Jr. | Physician Assistant | 67 Buckland Dr, Waterbury, CT 06704 | 2019-09-16 |
| 1912495797 | Jennie Webb | Physician Assistant | 2247 E Main St Ste 103, Waterbury, CT 06705 | 2018-04-26 |
| 1003188814 | Jodi Lasky | Physician Assistant | 26 Westport Dr, Waterbury, CT 06706-2854 | 2012-02-09 |
| 1255668968 | Michele C Pierce | Physician Assistant | 60 Westwood Ave Ste 314, Waterbury, CT 06708-2460 | 2009-11-17 |
| 1700035615 | Marissa L Stankus | Physician Assistant | 171 Grandview Ave Ste 201, Waterbury, CT 06708-2520 | 2008-09-16 |
| 1588699557 | Adriane Guerin | Physician Assistant | 179 Roseland Ave, Waterbury, CT 06710 | 2006-07-11 |
| 1407826522 | Deanna Michaud | Physician Assistant | 2247 E Main St, Suite 103, Waterbury, CT 06705 | 2006-01-23 |
| 1891777918 | Alan Robert Houle | Physician Assistant | 1211 W Main St, Waterbury, CT 06708-3106 | 2005-11-15 |
| 1750389375 | Huma Tariq Khaliq | Physician Assistant | 232 N Elm St, Waterbury, CT 06702-1516 | 2005-07-08 |
| Find all providers in WATERBURY | ||||
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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.