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Individual

PATRICK J CREEDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
28 CRESCENT ST, MIDDLESEX HOSPITAL, MIDDLETOWN, CT 06457-3654
(860) 358-6394
Mailing address
28 CRESCENT ST, MIDDLESEX HOSPITAL, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-8661

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001265
CT
363AS0400X
Surgical Physician Assistant
Primary
001265
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003012655
CT
Enumeration date
09/25/2006
Last updated
04/12/2017
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