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General NPI Number Information
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NPI Number | 1073390357
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Entity Type | Organization
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Legal Business Name | HARTFORD HOSPITAL
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 80 SEYMOUR ST
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City | HARTFORD
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State | CT
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Zip | 06102-8000
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Country | US
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Telephone | 860-545-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 21 STOWE ST
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City | MIDDLEFIELD
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State | CT
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Zip | 06455-1206
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Country | US
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Telephone | 860-803-7621
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Fax |
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Authorized Official
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Title or Position | AP MANAGER
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Name | JENNIFER FREUND
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Credential |
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Telephone | 860-209-3315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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