Healthcare Provider Details

I. General information

NPI: 1851546956
Provider Name (Legal Business Name): MS. CHRISTINE MARIE HEGEDUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 EAST MIDDLE TURNPIKE
MANCHESTER CT
06040-3731
US

IV. Provider business mailing address

587 EAST MIDDLE TURNPIKE
MANCHESTER CT
06040-3731
US

V. Phone/Fax

Practice location:
  • Phone: 860-646-3888
  • Fax: 860-645-4132
Mailing address:
  • Phone: 860-646-3888
  • Fax: 860-645-4132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: