Individual provider · Type 1 NPI
Natalie Marie Concannon, PA
Medical Physician Assistant · Waterford, CT
NPI number
1720422645
Active
Practice location
5 Dayton Rd Ste 205
Waterford, CT 06385-4279
Fax (860) 447-8961
Mailing address
136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Other practice locations
- 910 E 26th St, Suite 100, Minneapolis, MN 55404-4526 · (612) 884-6300
- 910 E 26th St, Suite 100, Minneapolis, MN 55404 · (612) 884-6300
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 25MP00473600 (NJ) |
| Medical Physician Assistant Primary | 363AM0700X | 5660 (CT) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Waterford
About NPI 1720422645
Natalie Marie Concannon, PA's National Provider Identifier is 1720422645, issued on Apr 22, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Waterford, CT. The record was last updated on Oct 23, 2025.