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Individual
LISA MARIE TANGUAY
Active
Individual
LISA MARIE TANGUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000863
CT
363AS0400X
Surgical Physician Assistant
Primary
000863
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008010398
—
CT
01
—
061470493
COVENTRY/FIRST HEALTH
CT
01
—
080863
CONNECTICARE
CT
01
—
208796
WELLCARE
CT
01
—
22-59899
AMERICHOICE
CT
01
—
290000863CT11
ANTHEM BCBS CT
CT
01
—
2V1632
HEALTHNET/COMMERCIAL
CT
01
—
877800
USA
CT
01
—
9886225
AETNA
CT
01
—
P3134207
OXFORD
CT
Enumeration date
06/25/2006
Last updated
05/07/2026
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