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General NPI Number Information
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NPI Number | 1366582363
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Entity Type | Organization
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Legal Business Name | EASTERN CT HEMATOLOGY & ONCOLOGY
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 330 WASHINGTON ST STE 220
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City | NORWICH
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State | CT
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Zip | 06360-2700
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Country | US
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Telephone | 860-886-8362
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Fax | 860-886-9262
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Provider Business Mailing Address
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Address Line | 330 WASHINGTON ST SUITE 220
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City | NORWICH
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State | CT
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Zip | 06360-2700
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Country | US
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Telephone | 860-886-8362
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Fax | 860-886-9262
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Authorized Official
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Title or Position | CREDENTIALING SPECIAILIST
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Name | JENNIFER ALEXANDER
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Credential |
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Telephone | 916-233-8607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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