Provider Demographics
NPI:1346467602
Name:FRIMEL, SANDRA (PAC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:FRIMEL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 BRAINARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:HIGGANUM
Mailing Address - State:CT
Mailing Address - Zip Code:06441-4069
Mailing Address - Country:US
Mailing Address - Phone:860-345-2883
Mailing Address - Fax:
Practice Address - Street 1:327 HIGH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06459-3232
Practice Address - Country:US
Practice Address - Phone:860-685-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000405363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant