Healthcare Provider Details

I. General information

NPI: 1043429806
Provider Name (Legal Business Name): BRISTOL HOSPITAL MULTI-SPECIALTY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 NEWELL RD STE E31
BRISTOL CT
06010-5140
US

IV. Provider business mailing address

PO BOX 2828
BRISTOL CT
06011-2828
US

V. Phone/Fax

Practice location:
  • Phone: 860-308-1020
  • Fax:
Mailing address:
  • Phone: 860-585-3906
  • Fax: 860-585-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRIS ANN MEANEY
Title or Position: PRESIDENT
Credential: DNP, MHA, FACHE
Phone: 860-585-3041