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General NPI Number Information
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NPI Number | 1689074148
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HEALTH ASSOCIATES PC.
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 576 FARMINGTON AVE
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City | HARTFORD
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State | CT
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Zip | 06105-3015
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Country | US
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Telephone | 347-556-7956
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Fax |
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Provider Business Mailing Address
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Address Line | 48 MAPLEHURST CT
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City | CHESHIRE
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State | CT
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Zip | 06410-1576
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Country | US
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Telephone | 347-556-7956
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | SACHIN DHINGRA
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Credential | MD
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Telephone | 347-556-7956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 045608
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License Number State | CT
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