Gulliford, Jill Wasserman
Gulliford, Jill Wasserman is an individual health care provider with primary practice located at 950 Campbell Ave , West Haven CT 06516-2770. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Gulliford, Jill Wasserman can be contacted via phone (203) 932-5711.Contact Information
Primary practice address
950 Campbell Ave
West Haven CT 06516-2770
Phone: (203) 932-5711
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 000773 | Connecticut |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 00773 | Connecticut |
Profile Details
NPI number | 1215982624 |
---|---|
LBN Legal business name | Gulliford, Jill Wasserman |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 23rd, 2006 |
Last updated | Sep 11th, 2023 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1215982624 | NPPES |
Connecticut | Other | 2V3798 | HEALTH NET |
Connecticut | Other | 290000773CT01 | HEALTH NET |
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