Provider Demographics
NPI:1417984576
Name:STRIPPOLI, KARA F (PA)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:F
Last Name:STRIPPOLI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 DIXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514
Mailing Address - Country:US
Mailing Address - Phone:203-230-4160
Mailing Address - Fax:203-848-2484
Practice Address - Street 1:2543 DIXWELL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514
Practice Address - Country:US
Practice Address - Phone:203-230-4160
Practice Address - Fax:203-848-2484
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
CT001730363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT970002073Medicare ID - Type Unspecified
CTQ63091Medicare UPIN
Q63091Medicare UPIN
CT970002458Medicare PIN