STATE OF CONNECTICUT HEALTH CENTER (NPI# 1669656575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669656575 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT HEALTH CENTER |
| Other Organization Name | PEDIATRIC HEMATOLOGY/ONCOLOGY |
| Practice Address |
263 Farmington Ave Pediatric Hematology/oncoloty Farmington CT 06030-0001 |
| Mailing Address |
263 Farmington Ave Provider Enrollment - Provider Enrollment Farmington CT 06030-2212 |
| Practice Telephone | 8606792100 |
| Practice Fax Number | 8606794815 |
| Mailing Telephone | 8606797503 |
| Mailing Fax Number | 8606791610 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2012-06-14 |
| Authorized Official Name | DENIS C LAFRENIERE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8606797503 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF CONNECTICUT HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
========= | CT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pediatric Hematology/Oncology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497055941 | State of Connecticut Health Center | Health Maintenance Organization | 263 Farmington Ave, Mc 5386, Farmington, CT 06030-5386 | 2010-11-01 |
| 1912165945 | State of Connecticut Health Center | Radiology | 263 Farmington Ave, Radiology Hbp Group, Farmington, CT 06030-0001 | 2008-05-27 |
| 1003074030 | State of Connecticut Health Center | Pathology | 263 Farmington Ave, Laboratory Hbp Group, Farmington, CT 06030-0001 | 2008-05-27 |
| 1811155849 | State of Connecticut Health Center | Obstetrics & Gynecology | 263 Farmington Ave, Ob/gyn Hbp Group, Farmington, CT 06030-0001 | 2008-05-27 |
| 1710156849 | State of Connecticut Health Center | Durable Medical Equipment & Medical Supplies | 850 Bolton Rd, U-85, Storrs Mansfield, CT 06269-9020 | 2008-02-22 |
| 1386821882 | State of Connecticut Health Center | Nurse Practitioner | 263 Farmington Ave, Aprn, Orthopaedics, Farmington, CT 06030-0001 | 2008-01-28 |
| 1104008408 | State of Connecticut Health Center | Internal Medicine | 263 Farmington Ave, Endrocrinology Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| 1295917599 | State of Connecticut Health Center | Internal Medicine | 263 Farmington Ave, Gastroenterology Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| 1528247541 | State of Connecticut Health Center | Durable Medical Equipment & Medical Supplies | 65 Kane St, West Hartford, CT 06119-2110 | 2007-10-26 |
| Street Address |
263 FARMINGTON AVE PEDIATRIC HEMATOLOGY/ONCOLOTY |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879519 | Michael Joseph Giordano | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-05-24 |
| 1891394995 | Ewa Jaszczolt | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-20 |
| 1295333458 | Brianne Catherine Bischoff | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-10 |
| 1023622073 | Michael John Arciszewski | Perfusionist | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-09-06 |
| 1073126199 | Esha Bhatt | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06032-1956 | 2020-08-28 |
| 1689286932 | Margaret Darin | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-18 |
| 1174133656 | Rosa Raquel Huivin | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-09 |
| 1336758051 | Sahar Zamani | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-07-28 |
| 1083222954 | Gabriela Maria Parra | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| 1780292680 | Bastian Andres Rojas Espinoza | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617606 | David Wozny | Student in an Organized Health Care Education/Training Program | General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-13 |
| 1508495185 | Zachary Boivin | Student in an Organized Health Care Education/Training Program | Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-06 |
| 1063903730 | Agura Afiari | Student in an Organized Health Care Education/Training Program | Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 | 2018-05-29 |
| 1750879474 | Areeba Siddiqui | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue Mc1921, Farmington, CT 06030 | 2018-04-27 |
| 1508362013 | Arya Saniee I | Student in an Organized Health Care Education/Training Program | 264 Farmington Ave, Farmington, CT 06030 | 2018-04-03 |
| 1679828594 | Randall Morera | Student in an Organized Health Care Education/Training Program | 262 Farmington Ave, Farmington, CT 06030 | 2012-07-17 |
| 1750644365 | Ugonna Ijeoma | Student in an Organized Health Care Education/Training Program | 260 Farmington Ave, Farmington, CT 06030 | 2012-06-19 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1851456495 | Jeffrey Gross | Anesthesiology | 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 | 2006-12-26 |
| 1649225269 | Julian Nieves | Internal Medicine | 263 Famrington Avenue, Farmington, CT 06030 | 2006-05-23 |
| Find all providers in zip 06030 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| 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) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134375058 | Sharon Lynn Space | Pediatrics | 565 Ashford Center Rd, Ashford, CT 06278-1720 | 2008-08-12 |
| 1871776856 | Pediatric Hematology-oncology Associates, PC | Pediatrics | 405 Church St, Guilford, CT 06437-2003 | 2007-12-12 |
| 1205906419 | Joseph Michael Mcnamara | Pediatrics | 405 Church Street, Guilford, CT 06437-2003 | 2006-11-08 |
| 1184093163 | Vidya Puthenpura | Pediatrics | 20 York St, New Haven, CT 06510 | 2015-09-18 |
| 1275945115 | Rozalyn Levine Rodwin | Pediatrics | 20 York St, New Haven, CT 06510-3220 | 2014-05-27 |
| 1235577792 | Stephanie Diana Prozora | Pediatrics | 20 York St # T-209, Yale-new Haven Hospital, New Haven, CT 06510-3220 | 2013-06-06 |
| 1295039675 | Yale Hemophilia Treatment Center | Pediatrics | 333 Cedar Street, Department of Pediatrics, 2073 Lmp, New Haven, CT 06520-8064 | 2010-12-29 |
| 1740508050 | Juan Vasquez | Pediatrics | 333 Cedar St, Lmp 2073, New Haven, CT 06510-3206 | 2010-05-11 |
| 1134350499 | Niketa C Shah | Pediatrics | 330 Cedar St, Lmp 2073, New Haven, CT 06510-3218 | 2009-08-05 |
| 1851534481 | Stephanie Ann Massaro | Pediatrics | 333 Cedar St, Lmp 2073, New Haven, CT 06520-8064 | 2009-04-13 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 06030 |
Please comment or provide details below to improve the information on STATE OF CONNECTICUT HEALTH CENTER.
| 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.