Individual
CARISSA L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL NEUROLOGY DEPT, HARTFORD, CT 06102-8000
(860) 972-3621
Mailing address
80 SEYMOUR STREET, HARTFORD HOSPITAL NEUROLOGY DEPT, HARTFORD, CT 06102-8000
(860) 972-3621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA061091
PA
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
005106
CT
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
10/07/2019
Last updated
06/02/2022
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