Provider Demographics
NPI:1497486070
Name:SCHOEN, MELISSA ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ASHLEY
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SAYBROOK RD STE A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4859
Mailing Address - Country:US
Mailing Address - Phone:860-636-2010
Mailing Address - Fax:
Practice Address - Street 1:420 SAYBROOK RD STE A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4859
Practice Address - Country:US
Practice Address - Phone:860-636-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005852363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical