Healthcare Provider Details

I. General information

NPI: 1689942559
Provider Name (Legal Business Name): KATHLEEN LEE SCHEINBERG RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2011
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 WETHERSFIELD AVE
HARTFORD CT
06114-1420
US

IV. Provider business mailing address

331 WETHERSFIELD AVE
HARTFORD CT
06114-1420
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-4511
  • Fax: 860-231-8449
Mailing address:
  • Phone: 860-236-4511
  • Fax: 860-231-8449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number080168
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4972
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: