Healthcare Provider Details

I. General information

NPI: 1366858193
Provider Name (Legal Business Name): BISHOY EMMANUEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

85 SEYMOUR ST STE 320
HARTFORD CT
06106-5502
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-4219
  • Fax: 860-545-4208
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS020015
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number68176
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: