MRS. LACEY BRYN LUNEAU (NPI# 1972821270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972821270 |
| Entity Type | Individual |
| Full Name | MRS. LACEY BRYN LUNEAU |
| Credential | PA-C |
| Practice Address |
320 Pomfret St Putnam CT 06260-1836 |
| Mailing Address |
94 S Main St Fl 1 Putnam CT 06260-1908 |
| Practice Telephone | 8609636486 |
| Mailing Telephone | 8027348824 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2014-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 002398 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002398 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
320 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417940271 | Marc B Cerrone | Pediatrics | 320 Pomfret St, Dkh Pediatric Center, Putnam, CT 06260-1836 | 2005-08-26 |
| 1265065551 | Vanmaly P. Sangasy | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2020-02-15 |
| 1952942310 | Jeremy Tyler Rockwell | Registered Nurse | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-10-07 |
| 1215588355 | Caitlyn Allyssa Sward | Dietitian, Registered | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-09-20 |
| 1164082301 | Julie Van Saun | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-06-19 |
| 1487127171 | Hartford Orthopedic Surgeons,pc | Durable Medical Equipment & Medical Supplies | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-01-07 |
| 1518434422 | Betsy Alvarado | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2018-10-29 |
| 1831601848 | Robyn A Martin | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-10-31 |
| 1922529098 | Raphaella Daggett | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-06-29 |
| 1770010399 | Gurkirat Singh Sandhu | Internal Medicine | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
| 1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
| 1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
| 1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
| 1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
| 1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
| 1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
| 1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629346127 | Day Kimball Hospital of Windham County | Physician Assistant | 320 Pomfret St, Suite Csb2, Putnam, CT 06260-1836 | 2011-12-12 |
| 1962736892 | Deirdre Lynn Monahan | Physician Assistant | 320 Pomfret St, Putnam, CT 06260 | 2009-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163671 | Kirsten Alexandra Drobiak | Physician Assistant | 37 Jennifer Ln, Griswold, CT 06351-3500 | 2020-10-28 |
| 1255955019 | Amanda Uscilla | Physician Assistant | 20 Hilltop Rd, Bethany, CT 06524-3514 | 2020-06-07 |
| 1689208571 | Sage Ann Miele | Physician Assistant | 149 Water St Apt 32, Norwalk, CT 06854-3758 | 2020-02-28 |
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1811547508 | Gabriela M Vargas | Physician Assistant | 24 Hospital Ave # Tower7, Danbury, CT 06810-6099 | 2019-09-16 |
| 1275192049 | Molly J Mable | Physician Assistant | 282 Washington St Fl 1, Hartford, CT 06106-3322 | 2019-06-06 |
| 1003377631 | Stephan Anton Bayer | Physician Assistant | 205 Elm St Apt 5, West Haven, CT 06516-4659 | 2019-03-27 |
| 1578024105 | Vance P Baughman | Physician Assistant | 325 Lafayette St Unit 1003, Bridgeport, CT 06604-5472 | 2019-03-27 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
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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.