Ileana Collazo

Individual provider Active NPI Case Manager/Care Coordinator · Hartford, CT

NPI 1134529316 · NPPES record last updated Aug 25, 2014

Key facts

NPI
1134529316
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1680 Albany Ave
Hartford, CT 06105-1001
Phone
(860) 236-4511
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1680 Albany Ave
Hartford, CT 06105-1001

Mailing address

1680 Albany Ave
Hartford, CT 06105-1001
Phone (860) 236-4511

Other providers in Hartford, CT

All providers in Hartford, CT · Case Manager/Care Coordinator in Connecticut

Sources for this page

Verify at the official NPI Registry.