DR. FONDA GRAVINO (NPI# 1952396020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952396020 |
| Entity Type | Individual |
| Full Name | DR. FONDA GRAVINO |
| Credential | M.D. |
| Practice Address |
99 Woodland St Hartford CT 06105-1207 |
| Practice Telephone | 8607144212 |
| Practice Fax Number | 8607148080 |
| Mailing Telephone | 8607144212 |
| Mailing Fax Number | 8607148080 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2013-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 042931 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1952396020 | 05 |
| Street Address |
99 WOODLAND ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06105-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093337909 | Laura Chaplin | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-05-13 |
| 1952930349 | Jared Michael Kozal | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-07 |
| 1568091007 | Nirali Patel | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-06 |
| 1922637917 | Yukari Ueda | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2020-04-02 |
| 1720540099 | Andria Danielle Matthews | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-04 |
| 1154883064 | Kiran A Lorick | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-01 |
| 1144782053 | Elizabeth Anne Darsan | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-04-01 |
| 1942760947 | Alex Mafdali | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2019-03-25 |
| 1700383015 | Kristen Alison Island | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2018-04-12 |
| 1942706197 | Kelley Sheller | Student in an Organized Health Care Education/Training Program | 99 Woodland St, Hartford, CT 06105-1207 | 2018-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1730743568 | Turab J Mohammed | Student in an Organized Health Care Education/Training Program | Saint Francis Hospital Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2019-04-26 |
| 1164900387 | Breanne Ferrara | Social Worker | 43 Wooland St, Hartford, CT 06105 | 2018-07-31 |
| 1154814069 | Signature Smiles of Hartford LLC | Dentist | 550 Farmington Avenue, Suite B, Hartford, CT 06105 | 2018-06-14 |
| 1356839062 | Jaimy Villavicencio | Student in an Organized Health Care Education/Training Program | 100 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2018-04-27 |
| 1750885679 | Brittany Bird | Student in an Organized Health Care Education/Training Program | 839-841 Asylum Avenue, Hartford, CT 06105 | 2018-03-23 |
| 1972032241 | Ashley Nicole Mills | Student in an Organized Health Care Education/Training Program | 896 Asylum Ave, 3rd Floor, Hartford, CT 06105 | 2017-06-08 |
| 1528506847 | Samuel Agyei | Social Worker | 291 Collins St, Hartford, CT 06105 | 2017-02-07 |
| 1841735818 | Katie Strahowski | Nurse Practitioner | 85 Gillett Street, Clean Slate, Hartford, CT 06105 | 2016-12-30 |
| Find all providers in zip 06105 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891159596 | Andrea Leigh Gillis | Family Medicine | Family Medicine Center At Asylum Hill, 99 Woodland St, Hartford, CT 06105 | 2016-04-08 |
| 1366679565 | William C Popik | Family Medicine | 90 Goodwin Cir, Hartford, CT 06105-5205 | 2009-06-15 |
| 1093989519 | Vivian Olsen Simmons | Family Medicine | 169 2nd Avenue, Hartford, AL 36344-1219 | 2008-04-15 |
| 1518130004 | Kamalpreet Dulai | Family Medicine | 110 Lone Oak Lane, Hartford, WI 53027 | 2008-04-07 |
| 1780877381 | Ohio County Hospital Corporation | Family Medicine | 20 Mcmurty Avenue, Hartford, KY 42347 | 2007-08-27 |
| 1912928169 | Collins Medical Associates 2 PC | Family Medicine | 95 Woodland St Fl 1, Hartford, CT 06105-1230 | 2006-07-22 |
| 1942225313 | Richard Thomas Kennedy | Family Medicine | 169 North Second Ave, Hartford, AL 36344 | 2006-07-13 |
| 1417908948 | Suzanne Gehl | Family Medicine | 1023 W State St, Hartford, WI 53027-2726 | 2006-05-12 |
| 1386609543 | Kellie Distefano | Family Medicine | 525 S Center St, Hartford, MI 49057-1362 | 2006-04-19 |
| 1851362180 | Kevin Lamont Collins | Family Medicine | 19 Woodland Street, Suite 42, Hartford, CT 06105 | 2006-01-26 |
| Find all providers in HARTFORD | ||||
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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.