Provider Demographics
NPI:1487700316
Name:SAVARESE, MICHELLE CATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CATHERINE
Last Name:SAVARESE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:CATHERINE
Other - Last Name:MATURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1000 ASYLUM AVE
Mailing Address - Street 2:SUITE 3208
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1770
Mailing Address - Country:US
Mailing Address - Phone:860-522-7121
Mailing Address - Fax:860-244-3516
Practice Address - Street 1:1000 ASYLUM AVE
Practice Address - Street 2:SUITE 3208
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1770
Practice Address - Country:US
Practice Address - Phone:860-522-7121
Practice Address - Fax:860-244-3516
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001848363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical