Provider Demographics
NPI:1194823575
Name:RISHEL, JOAN L (PA-C)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:L
Last Name:RISHEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:LIANE
Other - Last Name:NOTGHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:30 JORDAN LN
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1278
Mailing Address - Country:US
Mailing Address - Phone:860-263-0253
Mailing Address - Fax:860-263-0262
Practice Address - Street 1:342 N MAIN ST STE 350
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2500
Practice Address - Country:US
Practice Address - Phone:860-296-4022
Practice Address - Fax:860-772-0095
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0606363AM0700X
CT000552363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000552OtherSTATE PA LICENSE NUMBER
CT000552OtherSTATE PA LICENSE NUMBER
CT000552OtherSTATE PA LICENSE NUMBER