Healthcare Provider Details

I. General information

NPI: 1083174791
Provider Name (Legal Business Name): PATRICK HARTNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 08/07/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST STE 815
HARTFORD CT
06106-5527
US

IV. Provider business mailing address

1290 SILAS DEANE HIGHWAY HHC - CVO
WETHERSFIELD CT
06109
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-3600
  • Fax: 860-545-5003
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number82001
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number82001
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: