Healthcare Provider Details
I. General information
NPI: 1437109824
Provider Name (Legal Business Name): WOODLAND ANESTHESIA ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 WOODLAND ST
HARTFORD CT
06105-1208
US
IV. Provider business mailing address
114 WOODLAND ST
HARTFORD CT
06105-1208
US
V. Phone/Fax
- Phone: 860-714-6654
- Fax: 860-714-8110
- Phone: 860-714-6654
- Fax: 860-714-8110
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEO
CONTOIS
Title or Position: CHIEF OF ANESTHESIA
Credential: M.D.
Phone: 860-714-6654