Bousquet, Corey Craig

Bousquet, Corey Craig is an individual health care provider with primary practice located at 1918 Black Rock Tpke , Fairfield CT 06825-3543. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bousquet, Corey Craig can be contacted via phone (203) 583-8400.

Contact Information

Primary practice address
1918 Black Rock Tpke Fairfield CT 06825-3543
Phone: (203) 583-8400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9102466 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2478 Connecticut

Profile Details

NPI number 1598717571
LBN Legal business name Bousquet, Corey Craig
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jan 25th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598717571 NPPES
Florida Other 291035 AMERIGROUP
Florida MEDICAID 292171500 AMERIGROUP

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