Healthcare Provider Details

I. General information

NPI: 1558301689
Provider Name (Legal Business Name): HEBREW HOME AND HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ABRAHMS BLVD
WEST HARTFORD CT
06117-1508
US

IV. Provider business mailing address

1 ABRAHMS BLVD
WEST HARTFORD CT
06117-1508
US

V. Phone/Fax

Practice location:
  • Phone: 860-523-3800
  • Fax: 860-523-3949
Mailing address:
  • Phone: 860-523-3800
  • Fax: 860-523-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID A HOULE
Title or Position: EXECUTIVE VICE PRESIDENT & CFO
Credential:
Phone: 860-523-3895