Healthcare Provider Details

I. General information

NPI: 1336195015
Provider Name (Legal Business Name): HARTFORD ANESTHESIOLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST ANESTHESIA DEPT
HARTFORD CT
06108-3212
US

IV. Provider business mailing address

99 E RIVER DR FL 5 C/O IPMS
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-2117
  • Fax: 860-289-0834
Mailing address:
  • Phone: 860-282-4022
  • Fax: 860-282-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. EWA GASZEK
Title or Position: CREDENTIALER
Credential:
Phone: 860-282-4022