Provider Demographics
NPI:1942398276
Name:ROBERT, MAUREEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:ROBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BROAD BROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06016-9670
Mailing Address - Country:US
Mailing Address - Phone:860-623-1659
Mailing Address - Fax:860-645-3492
Practice Address - Street 1:27 HILLIARD ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-3001
Practice Address - Country:US
Practice Address - Phone:860-646-3903
Practice Address - Fax:860-645-3492
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-03-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant