Basic Information
Provider Information
NPI: 1255519864
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUTCHINSON
FirstName: NATASHA
MiddleName: KARENA
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: D'SOUZA
OtherFirstName: NATASHA
OtherMiddleName: KARENA
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 104 BARN FINCH CIR
Address2:  
City: NAUGATUCK
State: CT
PostalCode: 067704878
CountryCode: US
TelephoneNumber: 2036325832
FaxNumber:  
Practice Location
Address1: 1450 CHAPEL ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065114405
CountryCode: US
TelephoneNumber: 2037893000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2008
LastUpdateDate: 06/19/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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