Healthcare Provider Details

I. General information

NPI: 1730181348
Provider Name (Legal Business Name): AGATHA HECHT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 WOODLAND ST CANCER CENTER
HARTFORD CT
06105-1217
US

IV. Provider business mailing address

1000 ASYLUM AVE SUITE 2109A
HARTFORD CT
06105-1770
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-4680
  • Fax: 860-714-8057
Mailing address:
  • Phone: 860-714-6581
  • Fax: 860-714-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number003104
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: