MEDICARE: DR. HARRY HARTFORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	39792	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	110212380	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	043531502	OTHER	MA	CIGNA INDEMNITY
2	A56070	OTHER	MA	HARVARD
3	I22274	OTHER	MA	BCBS
4	039792	OTHER	MA	TUFTS
6	112266	OTHER	MA	MVP
7	043531502	OTHER	MA	HMC PPO
8	12919	OTHER	MA	HEALTH NEW ENGLAND
9	3871944	OTHER	MA	CIGNA/HEALTHSOURCE HMO
10	000000020929	OTHER	MA	HEALTHNET
11	10034388	OTHER	MA	CSPITAL PHYSICIANS HEALTH
12	043531502	OTHER	MA	GIC INDEMNITY
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669470456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY HARTFORD M.D.

Provider Business Mailing Address
First Line	:	777 NORTH ST STE 207
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4123
Country	:	US
Telephone Number	:	413-499-8510
Fax Number	:	413-499-8553

Provider Business Practice Location Address
First Line	:	777 NORTH ST
Second Line	:	207
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-4147
Country	:	US
Telephone Number	:	413-499-8510
Fax Number	:	413-499-8553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	09/20/2011

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