Basic Information
Provider Information
NPI: 1871070219
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADINOLFI
FirstName: HOLLY
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 18 RIVEREDGE ST
Address2:  
City: MILFORD
State: CT
PostalCode: 064607233
CountryCode: US
TelephoneNumber: 2038873414
FaxNumber:  
Practice Location
Address1: 20 YORK ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065103220
CountryCode: US
TelephoneNumber: 2036884242
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/27/2018
LastUpdateDate: 04/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X4143CTN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AM0700X4143CTY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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