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General NPI Number Information
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NPI Number | 1295683290
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Entity Type | Organization
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Legal Business Name | MANCHESTER MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 71 HAYNES ST
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City | MANCHESTER
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State | CT
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Zip | 06040-4131
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Country | US
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Telephone | 860-647-6824
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HWY 1ST FL - CVO DEPT
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4337
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Country | US
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Telephone | 860-972-3075
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Fax |
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT, FINANCIAL OP
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Name | GERALD BOISVERT
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Credential |
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Telephone | 860-263-4190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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