State of Connecticut
Organization Active NPI Psychiatric Hospital Unit · Farmington, CT
NPI 1902891682 · NPPES record last updated Jun 17, 2009
Key facts
- NPI
- 1902891682
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 00065 (CT)
- Legal business name
- STATE OF CONNECTICUT
- Practice address
- 263 Farmington Avenue
Farmington, CT 06030-5355 - Phone
- (860) 679-2916
- Fax
- (860) 679-3071
- NPI assigned
- Sep 19, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. John Biancamano
- Title
- Chief Financial Officer
- Phone
- (860) 679-1145
Practitioners 11
-
Judith M Fox, APRN
-
David C Ly, PA-C
-
Michael Abramov, M.D.
-
Ibrahim Elali, M.D.
-
Maxwell Fung, MD
-
Sharon R Goldberg, M.D.
-
Nikhila Kethireddy, M.D.
-
Kiran Sachdev, MD
-
Carolina Sueldo, M.D.
National Provider Directory
Locations
2222 East St
Ste 365
Concord, CA 94520
Phone (925) 686-1230
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 00065 | CT | Yes |
Addresses
Primary practice location
263 Farmington Avenue
Farmington, CT 06030-5355
Mailing address
263 Farmington Avenue
Farmington, CT 06030-5355
Phone (860) 679-2916
Other names
- John Dempsey Hospital- Subprovider
Other providers in Farmington, CT
- State of Connecitut Health Center
- State of Connecitut Health Center
- State of Connecitut Health Center
- State of Connecticut
- State of Connecticut
- State of Connecticut
- State of Connecticut Health Center
- State of Connecticut Health Center
- State of Connecticut Health Center
- State of Connecticut Health Center
All providers in Farmington, CT · Psychiatric Hospital Unit in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.