DR. GRAEL O'BRIEN (NPI# 1366454621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366454621 |
| Entity Type | Individual |
| Full Name | DR. GRAEL O'BRIEN |
| Credential | M.D. |
| Practice Address |
131 Coventry St Burgdorf Clinic - 2nd Floor Administration Hartford CT 06112-1548 |
| Practice Telephone | 8607143690 |
| Practice Fax Number | 8607148683 |
| Mailing Telephone | 8607143690 |
| Mailing Fax Number | 8607148683 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2013-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
039887 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CAQH | 10453102 | 01 |
| CT | 001398876-CL | 05 |
| Street Address |
131 COVENTRY ST BURGDORF CLINIC - 2ND FLOOR ADMINISTRATION |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982613303 | Jody Lynn Terranova | Pediatrics | 131 Coventry St, 2nd Floor, Hartford, CT 06112-1548 | 2006-08-05 |
| 1710506969 | Christi Rose Oommen | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2020-04-08 |
| 1952930455 | Brian Pablo Bustos | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2020-04-06 |
| 1588204952 | Luisa Maria Bernacet Rivera | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2020-01-13 |
| 1720540941 | Nabeel Salih | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2019-04-05 |
| 1912468174 | Ting Ting Wang | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2019-03-28 |
| 1447756242 | Jamie Kayla Haber | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2018-04-02 |
| 1861926982 | Chay Bae | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2017-04-14 |
| 1174056881 | Sobia Faisal | Student in an Organized Health Care Education/Training Program | 131 Coventry St, 2nd Floor, Hartford, CT 06112-1548 | 2017-04-10 |
| 1285098152 | Adnan Zaidi | Student in an Organized Health Care Education/Training Program | 131 Coventry St, Hartford, CT 06112-1548 | 2016-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1285933655 | Jessica Maccormac | Pediatrics | 282 Washington St, Hartford, CT 06106 | 2011-03-24 |
| 1245376771 | Anna George | Pediatrics | 500 Albany Ave, Hartford, CT 06120-2508 | 2007-01-30 |
| 1821042037 | Zeev Harel | Pediatrics | 500 Albany Ave, Hartford, CT 06120-2508 | 2006-05-20 |
| 1487652491 | Aric Schichor | Pediatrics | 1000 Asylum Ave, Suite 1026, Hartford, CT 06105-1770 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246306 | Pediatric Health Associates of Coneecticut, LLC | Pediatrics | 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 | 2019-07-03 |
| 1073943668 | Pediatric Walk In Care LLC | Pediatrics | 141 B Hazard Avenue, Enfield, CT 06082-5412 | 2013-11-18 |
| 1225319445 | Enfield Pediatric Associates,p.c. | Pediatrics | 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 | 2011-09-01 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1326166125 | Mary A. Simon | Pediatrics | 7 Melrose Dr, Farmington, CT 06032-0893 | 2007-03-27 |
| 1376678516 | Sydney Zane Spiesel | Pediatrics | 8 Lunar Dr, Woodbridge, CT 06525-2352 | 2007-02-21 |
| 1649314279 | Charles Ray Jones | Pediatrics | 111 Park St Ste F, New Haven, CT 06511-5412 | 2007-02-16 |
| 1427110469 | Radhika Malhotra | Pediatrics | 100 Bank St, Suite 307, Seymour, CT 06483-2806 | 2006-12-15 |
| 1386704682 | Andrews Adu Adade | Pediatrics | 18 Hillandale Ave, Stamford, CT 06902-2808 | 2006-12-11 |
| 1982706032 | John Gerald Pitegoff | Pediatrics | 1225 Silver St, Middletown, CT 06457-3920 | 2006-09-01 |
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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.