Active NPI
Maurita A. Eaton, PA-C
- Physician Assistant
- Stratford, CT
National Provider Identifier
1013154509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MP1079311
- Practice address
- 2876 Main St
Stratford, CT 06614-4984 - Phone
- (203) 386-3164
- NPI assigned
- Jan 21, 2009
- Last updated
- Jan 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MP1079311 | CT | Primary |
Addresses
Primary practice location
2876 Main St
Stratford, CT 06614-4984
Mailing address
27 Holcomb St
West Haven, CT 06516-7212
Phone (860) 558-7582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1425 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1013154509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 HOLCOMB ST",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065167212",
"telephone_number": "860-558-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2876 MAIN ST",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144984",
"telephone_number": "203-386-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "MAURITA",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "MP1079311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.