Individual
MICHELLE GORDON-CANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(925) 674-2880
(203) 688-4740
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4740
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6908
CT
363AM0700X
Medical Physician Assistant
PA17769
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA177690
—
CA
Enumeration date
08/14/2006
Last updated
05/12/2025
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