Individual provider · Type 1 NPI

Larisa Ann Gillern, PHYSICIAN ASSISTANT

Surgical Physician Assistant · Greenwich, CT

NPI number 1639793557 Active

Practice location

5 Perryridge Rd
Greenwich, CT 06830-4608

Call (203) 863-3000 Map

Mailing address

74 Ocean Ave
Milford, CT 06460-5341

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1639793557

Larisa Ann Gillern, PHYSICIAN ASSISTANT's National Provider Identifier is 1639793557, issued on Jun 5, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Greenwich, CT. The record was last updated on Oct 14, 2025.