Healthcare Provider Details

I. General information

NPI: 1184618381
Provider Name (Legal Business Name): FRANCIS VANNOSTRAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 E MAIN ST
STAFFORD SPRINGS CT
06076-1227
US

IV. Provider business mailing address

47 E MAIN ST
STAFFORD SPRINGS CT
06076-1227
US

V. Phone/Fax

Practice location:
  • Phone: 860-684-5848
  • Fax: 860-684-0469
Mailing address:
  • Phone: 860-684-5848
  • Fax: 860-684-0469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number022984
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: