HARTFORD HEALTHCARE MEDICAL GROUP, INC (NPI# 1568714970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568714970 |
| Entity Type | Organization |
| Organization Name | HARTFORD HEALTHCARE MEDICAL GROUP, INC |
| Practice Address |
330 Western Blvd Glastonbury CT 06033-4383 |
| Mailing Address |
1290 Silas Deane Hwy Wethersfield CT 06109-4337 |
| Practice Telephone | 8602462071 |
| Mailing Telephone | 8609727040 |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MARK BANCROFT VYE (VP ADMINISTRATION) |
| Authorized Official Telephone | 8609727858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164768255 | Hartford Healthcare Medical Group, Inc | Urology | 100 Hazard Ave, Ste. 206, Enfield, CT 06082-5446 | 2012-12-18 |
| 1619211182 | Hartford Healthcare Medical Group, Inc | Clinic/Center | 1025 Silas Deane Hwy, Wethersfield, CT 06109-4229 | 2012-11-21 |
| 1033461454 | Hartford Healthcare Medical Group, Inc | Podiatrist | 29 Haynes St, Manchester, CT 06040-4139 | 2012-10-09 |
| 1336491752 | Hartford Healthcare Medical Group, Inc | Urology | 455 Lewis Ave, Ste. 210, Meriden, CT 06451-2121 | 2012-10-09 |
| 1609128016 | Hartford Healthcare Medical Group, Inc | Podiatrist | 65 Memorial Rd, Ste. 430, West Hartford, CT 06107-2434 | 2012-10-09 |
| 1588916993 | Hartford Healthcare Medical Group, Inc | Podiatrist | 201 N Mountain Rd, Plainville, CT 06062-1848 | 2012-10-09 |
| 1780936104 | Hartford Healthcare Medical Group, Inc | Podiatrist | 1025 Silas Deane Hwy, Wethersfield, CT 06109-4229 | 2012-10-09 |
| 1851643258 | Hartford Healthcare Medical Group, Inc | Podiatrist | 85 Seymour St, Ste. 409, Hartford, CT 06106-5501 | 2012-10-09 |
| 1043561301 | Hartford Healthcare Medical Group, Inc | Psychiatry & Neurology | 1290 Silas Deane Hwy, Attn: Linda Straka, Wethersfield, CT 06109-4337 | 2012-09-27 |
| 1720140221 | Hartford Healthcare Medical Group, Inc | Plastic Surgery | 399 Farmington Ave, Suite 200, Farmington, CT 06032-1936 | 2006-12-14 |
| Street Address |
330 WESTERN BLVD |
| City | GLASTONBURY |
| State | CT |
| Zip Code | 06033-4383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033104765 | Darren Scott Tishler | Surgery | 330 Western Blvd, Glastonbury, CT 06033-1236 | 2005-09-19 |
| 1689206526 | Colleen Elizabeth Laskoski | Nurse Practitioner | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2020-02-09 |
| 1891330676 | Erin Meghan Daley | Registered Nurse | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2019-11-15 |
| 1750934998 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2019-07-17 |
| 1972074995 | Marisa Butler | Dietitian, Registered | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2018-12-17 |
| 1275813156 | Hartford Clinical Associates, PC | Podiatrist | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2011-08-23 |
| 1235419557 | Jennifer Wethje | Nurse Practitioner | 330 Western Blvd, Suite 102, Glastonbury, CT 06033-4383 | 2011-08-17 |
| 1124031737 | Catherine Brown | Physician Assistant | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2006-08-14 |
| 1417964123 | Pavlos K Papasavas | Surgery | 330 Western Blvd, Glastonbury, CT 06033-1236 | 2006-08-02 |
| 1356321574 | Dawn M.s. Garcia | Nurse Practitioner | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2006-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
| 1497284897 | D&l Eyecare | Optometrist | 33 Welles Street, Glastonbury, CT 06033 | 2017-06-08 |
| 1730626235 | Half Full Psychiatry LLC | Clinic/Center | 39 New London Tpke Ste 230f, Glastonbury, CT 06033 | 2017-01-23 |
| 1285000117 | Olga A Levkina | Physician Assistant | 2928 Main St Ste 101, Glastonbury, CT 06033 | 2015-08-14 |
| 1619350576 | Ryan Ilg Reichelt | Dentist | 131 New London Tpke Ste 211, Glastonbury, CT 06033 | 2015-07-09 |
| 1316320534 | Devon Banda | Orthopaedic Surgery | The Hand Center, 195 Eastern Blvd, # 200, Glastonbury, CT 06033 | 2015-07-07 |
| 1881073195 | Brittney Stanley | Counselor | 122 Naubuc Ave Ste 104, Glastonbury, CT 06033 | 2015-05-20 |
| 1780071878 | Richard T. Risinger | Dentist | 88 Citizens Drive, Glastonbury, CT 06033 | 2015-04-16 |
| 1639568751 | Carol Jane Gammell | Counselor | 140 Glastonbury Boulevard, Suite 30, Glastonbury, CT 06033 | 2015-01-13 |
| 1407262611 | Prashant Sinha | Dentist | 2874 Main Street, Glastonbury, CT 06033 | 2014-07-08 |
| Find all providers in zip 06033 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740834506 | Alledran Medical LLC | Durable Medical Equipment & Medical Supplies | 76 Eastern Blvd Unit D, Glastonbury, CT 06033-4382 | 2019-07-30 |
| 1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
| 1639492119 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1312 Manchester Rd, Glastonbury, CT 06033-1824 | 2010-03-11 |
| 1558458489 | M and M Industries, LLC | Durable Medical Equipment & Medical Supplies | 63-g Hebron Avenue, Glastonbury, CT 06033 | 2006-10-10 |
| 1295839199 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2639 Main St, Glastonbury, CT 06033-2023 | 2006-09-12 |
| 1336243260 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 766 New London Tpke, Glastonbury, CT 06033 | 2006-09-12 |
| 1386922151 | Dpmdeckerprct, LLC | Durable Medical Equipment & Medical Supplies | 300 Hebron Ave, Suite 211, Glastonbury, CT 06033-2176 | 2011-07-28 |
| 1992971857 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2900 Main St, Glastonbury, CT 06033-1027 | 2008-05-01 |
| 1275714123 | Hartford Orthopaedic Plastic & Hand Surgeons, Inc | Durable Medical Equipment & Medical Supplies | 195 Eastern Blvd, Suite 200, Glastonbury, CT 06033-1208 | 2007-11-20 |
| 1063531796 | Orthopaedic Sports Specialists, PC | Durable Medical Equipment & Medical Supplies | 84 Glastonbury Blvd, Suite 101, Glastonbury, CT 06033-4468 | 2007-03-27 |
| Find all providers in GLASTONBURY | ||||
| City | GLASTONBURY |
| Zip Code | 06033 |
Please comment or provide details below to improve the information on HARTFORD HEALTHCARE MEDICAL GROUP, INC.
| 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.