MEDICARE: NEUROLOGY ASSOCIATES OF GREATER HARTFORD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	13292	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1265409726	OTHER	CT	NPI

General Provider Information

NPI Number	:	1972893113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY ASSOCIATES OF GREATER HARTFORD PC

Provider Business Mailing Address
First Line	:	100 WELLS ST
Second Line	:	SUITE 1B
City	:	HARTFORD
State	:	CT
Zip	:	06103-2928
Country	:	US
Telephone Number	:	860-278-8937
Fax Number	:	860-244-2452

Provider Business Practice Location Address
First Line	:	100 WELLS ST
Second Line	:	SUITE 1B
City	:	HARTFORD
State	:	CT
Zip	:	06103-2928
Country	:	US
Telephone Number	:	860-278-8937
Fax Number	:	860-244-2452

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT H BERLAND
Credential	:	MD
Telephone Number	:	860-278-8937

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	04/08/2011

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