Healthcare Provider Details

I. General information

NPI: 1477534089
Provider Name (Legal Business Name): HOSPITAL FOR SPECIAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/07/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2266
US

IV. Provider business mailing address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2266
US

V. Phone/Fax

Practice location:
  • Phone: 860-612-6309
  • Fax: 860-832-6255
Mailing address:
  • Phone: 860-612-6309
  • Fax: 860-832-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number03CD
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number03CD
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number03CD
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number03CD
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number StateNULL
# 7
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number03CD
License Number StateCT

VIII. Authorized Official

Name: LAURIE A RUDMAN
Title or Position: SENIOR VICE PRESIDENT, CFO
Credential:
Phone: 860-612-6309