| Shannon Blake, PA | |
|
631 Quaker Ln S, West Hartford, CT 06110-1026 | |
| (860) 233-5133 | |
| (860) 232-6527 |
| Full Name | Shannon Blake |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 18 Years |
| Location | 631 Quaker Ln S, West Hartford, Connecticut |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578509238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 001550 (Connecticut) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lifesource Of North Carolina | 7416132428 | 154 |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Blake, PA 229 Henry St, Manchester, CT 06042-3243 Ph: (860) 371-5335 | Shannon Blake, PA 631 Quaker Ln S, West Hartford, CT 06110-1026 Ph: (860) 233-5133 |
Emma Woodward, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 65 Memorial Rd Ste 508, West Hartford, CT 06107 Phone: 860-696-2925 | |
Erica Falger, Physician Assistant Medicare: Medicare Enrolled Practice Location: 65 Memorial Rd Ste 435, West Hartford, CT 06107 Phone: 860-696-2840 Fax: 860-696-2845 | |
Ms. Marybeth Aucoin Moore, PA-C, MPH Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 631 Quaker Ln S, West Hartford, CT 06110 Phone: 860-233-5133 Fax: 860-233-5212 | |
Justin Hong, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 836 Farmington Ave Ste 207, West Hartford, CT 06119 Phone: 860-232-9911 | |
Vanessa C Pacholski, P.A.-C. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 970 Farmington Ave, Suite 201, West Hartford, CT 06107 Phone: 860-561-4300 Fax: 860-561-1635 | |
Mrs. Stephanie Gort, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 60 Barksdale Rd, West Hartford, CT 06117 Phone: 860-985-4188 | |
Audrey Kinnear Oweimrin, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 342 N Main St Ste 350, West Hartford, CT 06117 Phone: 860-296-4022 |