Healthcare Provider Details

I. General information

NPI: 1134393416
Provider Name (Legal Business Name): KRISTINE WELSH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

85 SEYMOUR STREET, SUITE 125B HARTFORD, CT 06106 SUITE 125B
HARTFORD CT
06106
US

V. Phone/Fax

Practice location:
  • Phone: 860-962-7022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7538
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3153
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: