NPIMap

Organization Active NPI

State of Connecticut Health Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Farmington, CT
National Provider Identifier
1003074030
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
CL0606 Issued in CT
Legal business name
STATE OF CONNECTICUT HEALTH CENTER
Practice address
263 Farmington Ave
Laboratory HBP Group
Farmington, CT 06030-0001
Phone
(860) 679-7503
Fax
(860) 679-1610
NPI assigned
May 27, 2008
Organization subpart
Yes
Parent organization
STATE OF CONNECTICUT HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denis C Lafreniere, MD
Title
Medical Director
Phone
(860) 679-7503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X CL0606 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Laboratory HBP Group
Farmington, CT 06030-0001

Mailing address

263 Farmington Ave
Provider Enrollment - Dowling South
Farmington, CT 06030-2212
Phone (860) 679-7503

Other identifiers 1

IdentifierTypeStateIssuer
500HBL432CT01OtherCTANTHEM BLUE CROSS

Other names 1

  • Anatomic Pathology HBP Group Other name

National Provider Directory

National Provider Directory
Tax ID family
University of Connecticut28 organizations share this tax ID, including this one
Part of
University of Connecticut

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1003074030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "PROVIDER ENROLLMENT - DOWLING SOUTH",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302212",
            "telephone_number": "860-679-7503",
            "fax_number": "860-679-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "LABORATORY HBP GROUP",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-7503",
            "fax_number": "860-679-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF CONNECTICUT HEALTH CENTER",
        "enumeration_date": "2008-05-27",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "LAFRENIERE",
        "authorized_official_first_name": "DENIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-679-7503",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "CL0606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "500HBL432CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anatomic Pathology HBP Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.