Individual
MRS. LARISA ANN GILLERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4608
(203) 863-3000
Mailing address
74 OCEAN AVE, MILFORD, CT 06460-5341
(203) 979-4882
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/05/2020
Last updated
10/14/2025
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