PROSPECT MANCHESTER HOSPITAL, INC. (NPI# 1316394638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316394638 |
| Entity Type | Organization |
| Organization Name | PROSPECT MANCHESTER HOSPITAL, INC. |
| Other Organization Name | MANCHESTER MEMORIAL HOSPITAL |
| Practice Address |
71 Haynes St Manchester CT 06040-4131 |
| Practice Telephone | 8606461222 |
| Mailing Telephone | 8606461222 |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-05-17 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3109434520 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Manchester Memorial Hospital | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695222 | Prospect Manchester Hospital, Inc. | Health Educator | 2800 Tamarack Ave Ste 100, South Windsor, CT 06074-5553 | 2020-10-08 |
| 1225484751 | Prospect Manchester Hospital, Inc. | Nurse Practitioner | 320 Main St, Manchester, CT 06040-4144 | 2016-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Prospect Manchester Hospital, Inc. | 3415 S. Sepulveda Blvd., 9th Floor, Los Angeles, CA 90034 |
| Street Address |
71 HAYNES ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568457893 | Monica Srodon | Specialist | 71 Haynes St, Manchester, CT 06040-4131 | 2005-09-13 |
| 1104443274 | Cynthia Lynn Kaczmarczyk | Occupational Therapist | 71 Haynes St, Manchester, CT 06040-4131 | 2020-07-06 |
| 1225653199 | Nicholas Orion Volaitis Cunningham | Student in an Organized Health Care Education/Training Program | 71 Haynes St, Manchester, CT 06040-4188 | 2020-06-16 |
| 1992327696 | Gavin Michael Hannon | Student in an Organized Health Care Education/Training Program | 71 Haynes St, Manchester, CT 06040-4131 | 2020-05-15 |
| 1548882830 | Izabela Anna Tomkiewicz | Student in an Organized Health Care Education/Training Program | 71 Haynes St, Manchester, CT 06040-4188 | 2020-05-11 |
| 1801418041 | Thomas Kim | Family Medicine | 71 Haynes St, Manchester, CT 06040-4131 | 2020-05-11 |
| 1508487075 | Michael Chiok | Student in an Organized Health Care Education/Training Program | 71 Haynes St, Manchester, CT 06040-4131 | 2020-05-06 |
| 1124657325 | Jennifer Neri | Physical Therapist | 71 Haynes St, Manchester, CT 06040-4131 | 2020-04-08 |
| 1366077646 | Kylie M Picard | Social Worker | 71 Haynes St, Manchester, CT 06040-4188 | 2020-03-07 |
| 1447884978 | Rachel Ellen Silvester | Physician Assistant | 71 Haynes St, Manchester, CT 06040-4188 | 2020-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501333 | Mackenzie Lawler | Social Worker | 200 W. Center Street, Suite C-2-6, Manchester, CT 06040 | 2020-05-29 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1346881596 | Sheryl Andrine Henry | Technician | 185 Pine Street, Apt 014, Manchester, CT 06040 | 2019-09-30 |
| 1811550304 | Edward Wahn Lee | Student in an Organized Health Care Education/Training Program | 130 Hartford Road, Manchester, CT 06040 | 2019-04-19 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1497275697 | Justin David Chung | Dentist | 483 Middle Tpke W Ste 209, Manchester, CT 06040 | 2017-06-20 |
| 1114473436 | Amanda Edgar | Counselor | 469 Center Street, Manchester, CT 06040 | 2016-08-28 |
| 1760831366 | Samantha Micael | Marriage & Family Therapist | 200 West Center Street, Suite C-2-6, Manchester, CT 06040 | 2016-06-06 |
| 1962856179 | Odelia Brew | Nurse Practitioner | 256 Hackmatack Street, Manchester, CT 06040 | 2016-04-14 |
| 1306217765 | Stephen R Machattie | Social Worker | 843 Main St Ste 11, Manchester, CT 06040 | 2015-10-12 |
| Find all providers in zip 06040 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336404169 | Manchester Memorial Hospital | General Acute Care Hospital | 71 Haynes St, Manchester, CT 06040-4131 | 2012-07-09 |
| 1740571397 | Eastern Connectitcut Medical Professionals | General Acute Care Hospital | 71 Haynes St, Suite 1209, Manchester, CT 06040-4131 | 2011-04-29 |
| 1760789143 | Amy Bacon-ford | General Acute Care Hospital | 1 Elliot Way, Manchester, NH 03103-3502 | 2011-02-21 |
| 1649417643 | Manchester Memorial Hospital | General Acute Care Hospital | 71 Haynes St., Patient Financial Services, Manchester, CT 06040-4105 | 2009-01-13 |
| 1508080391 | Elliot Hospital | General Acute Care Hospital | 275 Mammoth Rd, Suite 3, Manchester, NH 03109-4133 | 2007-04-12 |
| 1104995281 | Coffee Medical Group LLC | General Acute Care Hospital | 1001 Mcarthur St, Manchester, TN 37355-2419 | 2006-11-06 |
| 1902996028 | Elliot Hospital of The City of Manchester | General Acute Care Hospital | 1 Elliot Way, Manchester, NH 03103-3502 | 2006-10-13 |
| 1477653731 | Manchester Vamc | General Acute Care Hospital | 718 Smyth Rd, Manchester, NH 03104-7004 | 2006-09-25 |
| 1427154335 | Catholic Medical Center | General Acute Care Hospital | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1164815387 | Montefiore Hospital | General Acute Care Hospital | 15 Berrian Pl, Greenwich, CT 06830-6803 | 2015-03-12 |
| 1316295462 | Stamford Hospital | General Acute Care Hospital | 3 Cedargate Ln, Westport, CT 06880-3759 | 2012-08-21 |
| 1861756256 | Day Kimball Hospital | General Acute Care Hospital | 44 Hillcrest Dr, Vernon, CT 06066-4206 | 2012-06-29 |
| 1174830228 | Saint Raphael Hospital | General Acute Care Hospital | 1450, Chapel Street, Hospital of Saint Raphael, New Haven, CT 06511-2204 | 2010-09-10 |
| 1538485388 | University of Pittsburgh Medical Center | General Acute Care Hospital | 56 Hillside Pl, Apt 2, New Haven, CT 06511-3575 | 2010-04-19 |
| 1255586772 | Ynhh | General Acute Care Hospital | 56,hillside Pl., Apt No.2, New Haven, CT 06511 | 2008-11-25 |
| 1558511626 | Hartford Hospital | General Acute Care Hospital | 350 Russo Dr, Hamden, CT 06518-1757 | 2008-09-25 |
| 1932369907 | University of Connecticut Health Center | General Acute Care Hospital | 263 Farmington Ave # Mc-1119, Farmington, CT 06030-0001 | 2008-06-13 |
| 1316125107 | Ruben L Shapiro | General Acute Care Hospital | 15 Turnberry Ln, Bloomfield, CT 06002-2386 | 2008-02-05 |
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| City | MANCHESTER |
| Zip Code | 06040 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.