Provider Demographics
NPI:1487286563
Name:CASELLA, MICHAYLA (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAYLA
Middle Name:
Last Name:CASELLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHAYLA
Other - Middle Name:
Other - Last Name:MARCIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:408 MAROMAS RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5737
Mailing Address - Country:US
Mailing Address - Phone:978-502-7552
Mailing Address - Fax:
Practice Address - Street 1:280 CHESTNUT ST FL 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1001
Practice Address - Country:US
Practice Address - Phone:413-794-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant