Healthcare Provider Details

I. General information

NPI: 1770696643
Provider Name (Legal Business Name): HARTFORD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 11/27/2023
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 860-696-6010
  • Fax: 860-696-6190
Mailing address:
  • Phone: 860-696-6010
  • Fax: 860-696-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number046
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number0046
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number0046
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number046
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number046
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number046
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number0046
License Number StateCT
# 8
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0046
License Number StateCT

VIII. Authorized Official

Name: MR. THOMAS MARCHOZZI
Title or Position: V.P. FINANCE
Credential:
Phone: 860-545-2746