Healthcare Provider Details

I. General information

NPI: 1346281375
Provider Name (Legal Business Name): JONATHAN A ZEISLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR STREET HARTFORD HOSPITAL OB/GYN DEPT
HARTFORD CT
06102-5037
US

IV. Provider business mailing address

PO BOX 40,000 DEPT 634 HARTFORD PROFESSIONAL SERVICES
HARTFORD CT
06151-0634
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-2780
  • Fax:
Mailing address:
  • Phone: 860-545-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35087283
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35087283
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number35087283
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number047899
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: