KENDRA LASONIA MIRANDA PA NPI 1356422745

NPI Information

NPI: 1356422745
Provider Name: KENDRA LASONIA MIRANDA, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
80 SEYMOUR ST
HARTFORD HOSPITAL SURGERY DEPT - CRITICAL CARE
HARTFORD, CT
ZIP 06102
Phone: (860) 545-4670
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Kendra Lasonia Miranda, PA is a surgical physician assistant in Hartford, CT. Kendra Lasonia Miranda, PA NPI is 1356422745. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

80 SEYMOUR ST
HARTFORD HOSPITAL SURGERY DEPT - CRITICAL CARE
HARTFORD, CT
ZIP 06102-000
Phone: (860) 545-4670

The NPI 1356422745 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 5/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		001495	CONNECTICUT	No
2	363AM0700X	Physician Assistant	Medical	001495	CONNECTICUT	No
3	363AS0400X	Physician Assistant	Surgical	001495	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	970001770	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT	FOR CLINIC C00814
2	003014958	MEDICAID	CONNECTICUT
3	Q34494	MEDICARE UPIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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