Provider Demographics
NPI:1457530743
Name:HUNTINGTON, SUSAN RAMMER (PA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RAMMER
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:PROHEALTH PHYSICIANS
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5206
Mailing Address - Fax:860-678-4797
Practice Address - Street 1:4 FARM SPRINGS RD
Practice Address - Street 2:PROHEALTH PHYSICIANS
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2573
Practice Address - Country:US
Practice Address - Phone:860-284-5206
Practice Address - Fax:860-678-4797
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001970363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical