Healthcare Provider Details
I. General information
NPI: 1063461481
Provider Name (Legal Business Name): THE HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN GENERAL AND BRADLEY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 11/27/2023
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 GRAND ST
NEW BRITAIN CT
06052-2016
US
IV. Provider business mailing address
100 GRAND ST
NEW BRITAIN CT
06052-2016
US
V. Phone/Fax
- Phone: 860-224-5305
- Fax:
- Phone: 860-224-5575
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
R
NEWTON
Title or Position: SR. VICE PRESIDENT AND CFO
Credential:
Phone: 860-224-5575