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General NPI Number Information
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NPI Number | 1972665784
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Entity Type | Organization
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Legal Business Name | CITY OF HARTFORD
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 960 MAIN ST UNIT 8
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City | HARTFORD
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State | CT
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Zip | 06103-1225
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Country | US
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Telephone | 860-695-8852
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Fax | 860-722-8630
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Provider Business Mailing Address
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Address Line | 960 MAIN ST FL 9
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City | HARTFORD
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State | CT
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Zip | 06103-1218
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Country | US
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Telephone | 860-695-8852
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Fax | 860-722-8095
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Authorized Official
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Title or Position | COORDINATOR OF HEALTH SERVICES
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Name | DEBBIE CHAMEIDES
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Credential |
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Telephone | 860-695-8780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | CT
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