Candace Treadway, PA
Individual provider Active NPI Physician Assistant · Marlborough, CT
NPI 1891730107 · NPPES record last updated Feb 22, 2012
Key facts
- NPI
- 1891730107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 002028 (CT)
- Practice address
- 14 Jones Hollow Road
Marlborough, CT 06447 - Phone
- (860) 295-8217
- Fax
- (860) 295-9734
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins Emergency Medical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002028 | CT | Yes |
Addresses
Primary practice location
14 Jones Hollow Road
Marlborough, CT 06447
Mailing address
14 Jones Hollow Road
Marlborough, CT 06447
Phone (860) 295-8217
Other providers in Marlborough, CT
- Stuart L. Jablon, D.P.M.
- Vinsee Tang
- Lindsay Sarah Tarkington
- Thatcher'S Pharmcy Inc
- Total Balnce Center
- Mark D Tuttle
- Benedict Charles Valentine II
- Valley Physical Therapy & Sports Medicine Services, P.C.
- Valley Physical Therapy, LLC
- Allison Turner Villar
All providers in Marlborough, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.