Shelby L Blackley Valid NPI

Individual provider · Surgical Physician Assistant · Trumbull, CT

NPI

1518584259

Type

Individual (Type 1)

Primary specialty

Surgical Physician Assistant (Physician Assistant)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363AS0400X

License number

4908 (CT)

Sex

Female

Sole proprietor

No

Enumerated

2020-06-29

Last updated

2025-10-01