Healthcare Provider Details

I. General information

NPI: 1467586198
Provider Name (Legal Business Name): ONCOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RETREAT AVE
HARTFORD CT
06106-2527
US

IV. Provider business mailing address

85 RETREAT AVE
HARTFORD CT
06106-2527
US

V. Phone/Fax

Practice location:
  • Phone: 860-249-6291
  • Fax: 860-728-0151
Mailing address:
  • Phone: 860-249-6291
  • Fax: 860-728-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. STACY R NERENSTONE
Title or Position: PRESIDENT
Credential: MD
Phone: 860-249-6291