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General NPI Number Information
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NPI Number | 1275974321
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Entity Type | Organization
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Legal Business Name | GREATER HARTFORD PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 674 PROSPECT AVE
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City | HARTFORD
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State | CT
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Zip | 06105-4288
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Country | US
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Telephone | 917-683-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 674 PROSPECT AVENUE
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City | HARTFORD
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State | CT
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Zip | 06105
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Country | US
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Telephone | 917-683-2025
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Fax |
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Authorized Official
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Title or Position | CHILD AND ADOLESCENT PSYCHIATRIST
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Name | FRANCISCO RIPEPI
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Credential | MD
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Telephone | 917-683-2025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 046472
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 044819
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License Number State | CT
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