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NPI 1548257090

NPI 1548257090 : PETER A FORD APRN : FARMINGTON, CT

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General NPI Number Information
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    NPI Number           |    1548257090
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    Entity Type          |    Individual 
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    Provider Name        |    PETER A FORD APRN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/30/2005
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    Last Update Date     |    09/12/2025
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Provider Practice Location Address
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    Address Line         |    11 SOUTH RD STE 130 
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    City                 |    FARMINGTON
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    State                |    CT
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    Zip                  |    06032-2483
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    Country              |    US
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    Telephone            |    860-224-5433
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    Fax                  |    860-224-5933
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Provider Business Mailing Address
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    Address Line         |    85 SEYMOUR ST STE 415 
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    City                 |    HARTFORD
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    State                |    CT
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    Zip                  |    06106-5523
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    Country              |    US
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    Telephone            |    860-246-2071
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    Fax                  |    860-524-2650
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP2300X
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    Taxonomy Name        |    Primary Care Nurse Practitioner
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    License Number       |    001918
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    License Number State |    CT
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