Basic Information
Provider Information
NPI: 1750641270
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LACHAPPELLE
FirstName: ASHLEY
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
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Mailing Information
Address1: 114 WOODLAND ST
Address2: CARDIOLOGY
City: HARTFORD
State: CT
PostalCode: 061051208
CountryCode: US
TelephoneNumber: 8607144202
FaxNumber: 8607148001
Practice Location
Address1: 1000 ASYLUM AVE
Address2: SUITE 2109A
City: HARTFORD
State: CT
PostalCode: 061051770
CountryCode: US
TelephoneNumber: 8607146581
FaxNumber: 8607148311
Other Information
ProviderEnumerationDate: 05/17/2012
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
363AS0400X2776CTY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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