Provider Demographics
NPI:1013024561
Name:HIGHMAN, HENRY AINSLEY (PA)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:AINSLEY
Last Name:HIGHMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2142
Mailing Address - Country:US
Mailing Address - Phone:203-789-2272
Mailing Address - Fax:203-865-8614
Practice Address - Street 1:2 DEVINE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2142
Practice Address - Country:US
Practice Address - Phone:203-789-2272
Practice Address - Fax:203-865-8614
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S81941Medicare UPIN
970000686Medicare ID - Type Unspecified