Healthcare Provider Details

I. General information

NPI: 1619135977
Provider Name (Legal Business Name): ANN-MARIE SURETTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
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 DEPT OF
HARTFORD CT
06105-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-830-7383
  • Fax:
Mailing address:
  • Phone: 860-830-7383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberCT051362
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number266724
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number051362
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: