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General NPI Number Information
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NPI Number | 1710809942
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Entity Type | Organization
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Legal Business Name | GREATER HARTFORD PEDIATRICS LLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 465 SILAS DEANE HWY
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City | WETHERSFIELD
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State | CT
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Zip | 06109-2134
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Country | US
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Telephone | 860-303-7309
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Fax |
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Provider Business Mailing Address
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Address Line | 1077 SILAS DEANE HWY # 173
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4229
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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 | OWNER
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Name | DR. LATESHA THOMAS
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Credential | MD
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Telephone | 860-303-7309
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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 |
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License Number State |
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