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General NPI Number Information
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NPI Number | 1578087375
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Entity Type | Individual
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Provider Name | HILDA MARFO BOATENG PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 85 LAFAYETTE ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1803
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Country | US
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Telephone | 860-224-3642
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Fax | 860-224-2760
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Provider Business Mailing Address
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Address Line | 19 GRAND ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2705
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Country | US
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Telephone | 860-347-6971
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Fax | 860-343-7379
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA059185
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 4068
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4068
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License Number State | CT
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