Healthcare Provider Details
I. General information
NPI: 1679622898
Provider Name (Legal Business Name): DENISE E ABBATE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
675 TOWER AVE SUITE 301
HARTFORD CT
06112-1273
US
IV. Provider business mailing address
675 TOWER AVE SUITE 301
HARTFORD CT
06112-1273
US
V. Phone/Fax
- Phone: 860-714-2750
- Fax: 860-714-8591
- Phone: 860-714-2747
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 002460 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 002460 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: