Healthcare Provider Details

I. General information

NPI: 1336351048
Provider Name (Legal Business Name): SAMYA HASHEM HAWLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 ALBANY AVE
HARTFORD CT
06105-1001
US

IV. Provider business mailing address

12 CLEAR BRK
FARMINGTON CT
06032-2750
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-4511
  • Fax: 860-523-4805
Mailing address:
  • Phone: 860-284-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number040650
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: