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Individual

MRS. JAKELINNE E CABALLERO-ASTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA-C

Contact information

Practice address
111 OSBORNE STREET, DANBURY, CT 06810
(203) 739-7038
Mailing address
P.O. BOX 8932, BELFAST, ME 04915-8932
(203) 739-7038

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002767
CT
363AM0700X
Medical Physician Assistant
012141-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061137
WCMG TAX ID #
CT
Enumeration date
01/25/2008
Last updated
09/04/2012
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