Hartford Healthcare Medical Group Specialists LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC

Practice address

65 Memorial Rd Ste 430
West Hartford, CT 06107-4220

Phone

(860) 678-1050

NPI assigned

Jul 17, 2019

Last updated

Jul 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Bancroft Vye

Title

VP Administration

Phone

(860) 972-7858

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1629621891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 430",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074220",
            "telephone_number": "860-678-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "VYE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "BANCROFT",
        "authorized_official_title_or_position": "VP ADMINISTRATION",
        "authorized_official_telephone_number": "860-972-7858"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Julian Norris Hartt Jr., LCSW
• Dana Ashley Harvey, LMSW
• Michelle Marie Haudegand-Gough, OT/L
• Jacqueline Foster Haughton, COTA/L

• Durable Medical Equipment & Medical Supplies in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.