Healthcare Provider Details

I. General information

NPI: 1225110133
Provider Name (Legal Business Name): MAURA B PAULI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR STREET HARTFORD HOSPITAL ADULT PRIMARY CARE
HARTFORD CT
06102
US

IV. Provider business mailing address

HARTFORD HOSPITAL PROFESSIONAL SERVICES PO BOX 40,000 DEPT 634
HARTFORD CT
06151-0634
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-0200
  • Fax:
Mailing address:
  • Phone: 860-545-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number000882
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: