Healthcare Provider Details

I. General information

NPI: 1700974722
Provider Name (Legal Business Name): JOAN K GELIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST FRANCIS HOSPITAL 114 WOODLAND ST
HARTFORD CT
06105
US

IV. Provider business mailing address

84 PROSPECT ST
MANCHESTER CT
06040-5802
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-4000
  • Fax:
Mailing address:
  • Phone: 480-789-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number38696
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: