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General NPI Number Information
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NPI Number | 1023263134
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERAN AFFAIRS
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 555 WILLARD AVE 2C-1147
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City | NEWINGTON
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State | CT
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Zip | 06111-2631
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Country | US
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Telephone | 860-594-6353
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Fax | 860-667-6721
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Provider Business Mailing Address
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Address Line | 555 WILLARD AVE 2C-1147
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City | NEWINGTON
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State | CT
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Zip | 06111-2631
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Country | US
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Telephone | 860-594-6353
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Fax | 860-667-6721
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. DARLA FRENCH
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Credential | LCSW
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Telephone | 203-479-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 002830
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License Number State | CT
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