Healthcare Provider Details

I. General information

NPI: 1417360827
Provider Name (Legal Business Name): EMILY MENSEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST DEPARTMENT OF TRAUMATOLOGY/EMERGENCY MEDICINE
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

80 SEYMOUR ST DEPARTMENT OF TRAUMATOLOGY/EMERGENCY MEDICINE
HARTFORD CT
06102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-1448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number56459
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: