Individual
SHANNON CAREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
263 FARMINGTON AVENUE, FARMINGTON, CT 06030-8040
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-2100
(860) 679-4815
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002456
CT
363AM0700X
Medical Physician Assistant
002456
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002456
CT LICENSE
CT
Enumeration date
09/24/2010
Last updated
08/04/2025
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