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General NPI Number Information
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NPI Number | 1467760207
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH CORP
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 1028 BOULEVARD STE 178
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1801
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Country | US
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Telephone | 860-796-9752
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 BOULEVARD STE 178
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARK PRETE
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Credential |
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Telephone | 860-796-9752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 030593
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License Number State | CT
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