Active NPI
Lucinda Gilligan, PA
- Physician Assistant
- Manchester, CT
National Provider Identifier
1689947707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001075
- Practice address
- 335 Broad St
Manchester, CT 06040-4036 - Phone
- (860) 293-3101
- NPI assigned
- Feb 21, 2012
- 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 | 001075 | CT | Primary |
Addresses
Primary practice location
335 Broad St
Manchester, CT 06040-4036
Mailing address
8 Valley View Dr
Bloomfield, CT 06002-1632
Phone (860) 242-4439
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001075 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1689947707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 VALLEY VIEW DR",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060021632",
"telephone_number": "860-242-4439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 BROAD ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404036",
"telephone_number": "860-293-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIGAN",
"first_name": "LUCINDA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "001075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.