Healthcare Provider Details

I. General information

NPI: 1396814174
Provider Name (Legal Business Name): LAWRENCE ENGMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 11/18/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RETREAT AVE SUITE 900
HARTFORD CT
06106-2528
US

IV. Provider business mailing address

100 RETREAT AVE SUITE 900
HARTFORD CT
06106-2528
US

V. Phone/Fax

Practice location:
  • Phone: 860-525-8283
  • Fax: 860-525-1930
Mailing address:
  • Phone: 860-525-8283
  • Fax: 860-525-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number412285
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: