Healthcare Provider Details

I. General information

NPI: 1215620141
Provider Name (Legal Business Name): LINA M ARANGO-MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1678 ASYLUM AVE
WEST HARTFORD CT
06117-2764
US

IV. Provider business mailing address

111 PARK ST
HARTFORD CT
06106-2520
US

V. Phone/Fax

Practice location:
  • Phone: 860-841-9084
  • Fax:
Mailing address:
  • Phone: 860-972-2780
  • Fax: 860-972-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number12178
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: