Healthcare Provider Details
I. General information
NPI: 1770584724
Provider Name (Legal Business Name): JAMES M OHARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/02/2005
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 KENSINGTON AVENUE GROVE HILL MEDICAL CENTER
NEW BRITAIN CT
06051
US
IV. Provider business mailing address
300 KENSINGTON AVE GROVE HILL MEDICAL CENTER
NEW BRITAIN CT
06051-3999
US
V. Phone/Fax
- Phone: 860-832-8150
- Fax: 860-224-6298
- Phone: 860-832-8150
- Fax: 860-224-6298
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 028121 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: