Individual provider · Type 1 NPI

Kylie Tanabe, PA-C

Surgical Physician Assistant · Norwalk, CT

NPI number 1417324344 Active

Practice location

40 Prospect Ave, Building 2, 4C
Norwalk, CT 06850-3737

Call (207) 671-0235 Map

Mailing address

24 Stevens St, Building 2, 4C
Norwalk, CT 06850-3852

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X3407 (CT)
Surgical Physician Assistant 363AS0400X3407 (CT)
Surgical Physician Assistant Primary 363AS0400X54130 (CA)

Surgical Physician Assistant: Definition to come...

2 other providers at this address

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About NPI 1417324344

Kylie Tanabe, PA-C's National Provider Identifier is 1417324344, issued on Aug 26, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Norwalk, CT. The record was last updated on Feb 24, 2017.