Healthcare Provider Details

I. General information

NPI: 1548536105
Provider Name (Legal Business Name): COLIN J HUGUENEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR STREET HARTFORD HOSPITAL EMERGENCY MEDICINE
HARTFORD CT
06102-5037
US

IV. Provider business mailing address

80 SEYMOUR STREET HARTFORD HOSPITAL EMERGENCY MEDICINE
HARTFORD CT
06102-5037
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-0000
  • Fax:
Mailing address:
  • Phone: 860-972-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number252297
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number054895
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number261840
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: