Healthcare Provider Details

I. General information

NPI: 1801849146
Provider Name (Legal Business Name): HARTFORD PHYSICIAN'S MANAGEMENT CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAIN ST UNIT N1
HARTFORD CT
06106-1806
US

IV. Provider business mailing address

601 CHAPEL AVE E SUITE B
CHERRY HILL NJ
08034-1407
US

V. Phone/Fax

Practice location:
  • Phone: 860-525-1900
  • Fax: 860-522-9913
Mailing address:
  • Phone: 856-356-4025
  • Fax: 856-356-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number0009
License Number StateCT

VIII. Authorized Official

Name: ANGELA LAZARUS
Title or Position: COO
Credential: JD
Phone: 856-356-4000