Healthcare Provider Details

I. General information

NPI: 1952437923
Provider Name (Legal Business Name): STATE OF CT. - OFFICE OF THE COMPTROLLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 CAPITOL AVE
HARTFORD CT
06106-1308
US

IV. Provider business mailing address

460 CAPITOL AVE
HARTFORD CT
06106-1308
US

V. Phone/Fax

Practice location:
  • Phone: 860-418-6147
  • Fax: 860-418-6003
Mailing address:
  • Phone: 860-418-6147
  • Fax: 860-418-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. VINCENT L O'CONNELL
Title or Position: CHIEF ADMINISTRATIVE AND FISCAL SER
Credential:
Phone: 860-418-6163