Healthcare Provider Details

I. General information

NPI: 1679588198
Provider Name (Legal Business Name): AUGUSTO PARRA M.D., M.P.H, FAHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR STREET HARTFORD HOSPITAL NEUROLOGY DEPT
HARTFORD CT
06102-5037
US

IV. Provider business mailing address

80 SEYMOUR STREET P.O. BOX 5037 HARTFORD HOSPITAL NEUROLOGY DEPT
HARTFORD CT
06102-5037
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-3621
  • Fax:
Mailing address:
  • Phone: 860-972-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number62003
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number062003
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: