Basic Information
| Provider Information | |||||||||
| NPI: | 1881670933 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLAY | ||||||||
| FirstName: | ADELE | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ISKRA | ||||||||
| OtherFirstName: | ADELE | ||||||||
| OtherMiddleName: | L | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | APRN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2110 SILAS DEANE HWY | ||||||||
| Address2: | STARLING PHYSICIANS | ||||||||
| City: | ROCKY HILL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060672313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602583470 | ||||||||
| FaxNumber: | 8605716800 | ||||||||
| Practice Location | |||||||||
| Address1: | 375 WILLARD AVE | ||||||||
| Address2: | STARLING PHYSICIANS | ||||||||
| City: | NEWINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061112300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606665111 | ||||||||
| FaxNumber: | 8608264957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 01/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 003229 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LX0001X | 003229 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 004221959 | 05 | CT | MEDICAID | 370018 | 01 | CT | WELLCARE MEDICARE | OTHER | 2V7383 | 01 | CT | HEALTH NET | OTHER | 322900 | 01 | CT | CONNECTICARE | OTHER | 400003229CT02 | 01 | CT | BCBS NEWINGTON LOCATION | OTHER | 1255448155 | 01 | CT | GHMC GROUP NPI | OTHER | 004224846 | 01 | CT | MEDICAID GROUP PROVIDER N | OTHER | 400003229CT01 | 01 | CT | BCBS PLAINVILLE LOCATION | OTHER | P3654104 | 01 | CT | OXFORD | OTHER |