Individual provider · Type 1 NPI

Kendra Lasonia Miranda, PA

Surgical Physician Assistant · Hartford, CT

NPI number 1356422745 Active

Practice location

80 Seymour St, Hartford Hospital Surgery Dept - Critical Care
Hartford, CT 06102-8000

Call (860) 545-4670 Map

Mailing address

PO Box 415933, Hartford Hospital Professsional Services
Boston, MA 02241-5933

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X001495 (CT)
Medical Physician Assistant 363AM0700X001495 (CT)
Surgical Physician Assistant Primary 363AS0400X001495 (CT)

Surgical Physician Assistant: Definition to come...

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About NPI 1356422745

Kendra Lasonia Miranda, PA's National Provider Identifier is 1356422745, issued on Oct 18, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Hartford, CT. The record was last updated on May 6, 2013.