NPIMap

Organization Active NPI

Grace Center for Hematology & Oncology Care LLC

  • Hematology & Oncology Physician
  • Bristol, CT
National Provider Identifier
1285880088
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036026 Issued in CT
Legal business name
GRACE CENTER FOR HEMATOLOGY & ONCOLOGY CARE LLC
Practice address
45 N Main St
Bristol, CT 06010-8105
Phone
(860) 539-3360
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Authorized official

Name
Dr. Virginia Maria Tjan-Wettstein, M.D.
Title
Owner
Phone
(860) 539-3360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X 036026 CT Primary

Addresses

Primary practice location

45 N Main St
Bristol, CT 06010-8105

Mailing address

45 N Main St
Bristol, CT 06010-8105
Phone (860) 539-3360

National Provider Directory

National Provider Directory

Locations

45 N Main St
Bristol, CT 06010
Phone (860) 539-3360

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1285880088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108105",
            "telephone_number": "860-539-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108105",
            "telephone_number": "860-539-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CENTER FOR HEMATOLOGY & ONCOLOGY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "TJAN-WETTSTEIN",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-539-3360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "036026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.