Gaston, Samuel W.

Gaston, Samuel W. is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-0001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Gaston, Samuel W. can be contacted via phone (860) 679-2290.

Contact Information

Primary practice address
263 Farmington Ave Farmington CT 06030-0001
Phone: (860) 679-2290
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 000828 Connecticut

Profile Details

NPI number 1316003908
LBN Legal business name Gaston, Samuel W.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Sep 20th, 2022 - about 4 years ago

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 1316003908 NPPES
Connecticut MEDICAID 1316003908

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