Healthcare Provider Details

I. General information

NPI: 1215925037
Provider Name (Legal Business Name): JEFFREY S HYAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9560
  • Fax: 860-545-9561
Mailing address:
  • Phone: 860-545-9560
  • Fax: 860-545-9561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number022027
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: