MS. JACQUELINE LEE HARTZLER (NPI# 1336112051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336112051 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE LEE HARTZLER |
| Credential | MD |
| Practice Address |
21 Grand St Hartford CT 06106 |
| Practice Telephone | 8605507500 |
| Practice Fax Number | 8605507501 |
| Mailing Telephone | 8605507500 |
| Mailing Fax Number | 8605507501 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 040712 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | MD STATE OF CT | 040712 | 01 |
| CT | CONTROLLED SUBSTANCE | 38722 | 01 |
| Street Address |
21 GRAND ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364653 | Jennifer A Colucci | Nurse Practitioner | 21 Grand St, Hartford, CT 06106-1541 | 2005-05-23 |
| 1518583780 | Ludwig V Rosiclair | Pharmacist | 21 Grand St, Hartford, CT 06106-1541 | 2020-06-23 |
| 1235752866 | Philip Jacob Bergen Jr. | Physician Assistant | 21 Grand St, Hartford, CT 06106-1541 | 2020-05-18 |
| 1982243580 | Melissa Richardson | Nurse Practitioner | 21 Grand St, Hartford, CT 06106-1541 | 2019-12-30 |
| 1841838596 | Kristal Velazquez | Midwife | 21 Grand St, Hartford, CT 06106-1541 | 2019-12-12 |
| 1346888237 | Jillian Smith | Advanced Practice Midwife | 21 Grand St, Hartford, CT 06106-1541 | 2019-12-11 |
| 1467002634 | Stephanie Marie Watson | Physician Assistant | 21 Grand St, Hartford, CT 06106-1541 | 2019-09-18 |
| 1598311763 | Joeli Mcquaid-robert | Social Worker | 21 Grand St, Hartford, CT 06106-1541 | 2019-08-14 |
| 1487207718 | Andrea Fachini | Physician Assistant | 21 Grand St, Hartford, CT 06106-1541 | 2019-07-16 |
| 1831758366 | Kelly Ruiz | Physician Assistant | 21 Grand St, Hartford, CT 06106-1541 | 2019-06-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
| 1316501687 | Rafae Shaikh | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-04-23 |
| 1437643715 | Lucas Bensa | Social Worker | 421 Washington St., Apt C1, Hartford, CT 06106 | 2018-06-19 |
| 1548754310 | Collin Dimler | Physician Assistant | 85 Seymour St Ste 1003, Hartford, CT 06106 | 2018-06-15 |
| 1619460581 | Bryan F Stringer | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 | 2018-06-14 |
| 1083103972 | Margret Sigurdardottir Blondal | Student in an Organized Health Care Education/Training Program | 282 Washington Street, Ste 4h, Hartford, CT 06106 | 2018-05-07 |
| 1265920995 | Rudra Ramanathan | Student in an Organized Health Care Education/Training Program | 79 Retreat Ave Brown Stone, Hartford, CT 06106 | 2018-04-27 |
| Find all providers in zip 06106 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851640775 | Tricia Rita Pinto | Pediatrics | 21 Woodland St Ste 115, Hartford, CT 06105-4318 | 2012-09-06 |
| 1922353101 | Fredericka Wolman | Pediatrics | 505 Hudson St, Hartford, CT 06106-7107 | 2012-07-13 |
| 1528328184 | Caitlin Marie Heyden | Pediatrics | 282 Washington St Ste 2b, Hartford, CT 06106-3322 | 2012-05-16 |
| 1720272974 | Amy Carlucci Wu | Pediatrics | 282 Washington St., 2b, Hartford, CT 06106 | 2007-08-30 |
| 1720121122 | Virginia Howell Rittner | Pediatrics | Ssa, 309 Wawarme Ave, Hartford, CT 06114 | 2007-02-15 |
| 1306923313 | Donnie D Bouchard | Pediatrics | 63559 60th Ave, Hartford, MI 49057-8662 | 2006-11-01 |
| 1982613303 | Jody Lynn Terranova | Pediatrics | 131 Coventry St, 2nd Floor, Hartford, CT 06112-1548 | 2006-08-05 |
| 1609812080 | Jody Elizabeth Navitsky | Pediatrics | 75 New Britain Ave, Hartford, CT 06106 | 2006-06-22 |
| 1457302820 | Glenn Flores | Pediatrics | Connecticut Children's Specialty Group, 282 Washington Street, Hartford, CT 06106-3322 | 2006-05-12 |
| 1225024672 | Amira M Mohamed Ahmed | Pediatrics | 1000 Asylum Avenue, Hartford, CT 06105 | 2005-09-21 |
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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.