Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tiah Lanae Booker, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1093527616

Tiah Lanae Booker, PHYSICIANASSISTANT is a Physician Assistant in Hamden, Connecticut. Qualified in 2025, 1 year ago. Practices with Icahn School of Medicine at Mount Sinai, a 2,791-clinician group and accepts Medicare assignment. Licensed in Connecticut and New York.

Years since qualifying
1
Licensed in
CT, NY
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

900 Mix Ave Apt 28
Hamden, CT 06514-5107
Phone: (203) 444-7019
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)
Physician Assistant Taxonomy 363A00000X (CT)

Record details

NPI number1093527616
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJanuary 21, 2025
Last updated in NPPESJanuary 21, 2025
Certification dateJanuary 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Icahn School Of Medicine At Mount Sinai — 2791 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hamden