ILHAM DERHAN PUTRA (NPI# 1770110389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770110389 |
| Entity Type | Individual |
| Full Name | ILHAM DERHAN PUTRA |
| Practice Address |
80 Seymour St Hartford CT 06102-8000 |
| Practice Telephone | 7735010676 |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
80 SEYMOUR ST |
| City | HARTFORD |
| State | CT |
| Zip Code | 06102-8000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942207394 | Avinash Prasad | Psychiatry & Neurology | 80 Seymour St, Hartford Hospital Neurology Dept, Hartford, CT 06102-8000 | 2005-06-30 |
| 1215535935 | Lataya Hewitt | Nurse Practitioner | 80 Seymour St, Hartford, CT 06106-3315 | 2020-10-14 |
| 1629685938 | Nicole Martina | Nurse Practitioner | 80 Seymour St, Hartford, CT 06106-3315 | 2020-09-30 |
| 1477168011 | Cassidy Goodwin | Nurse Practitioner | 80 Seymour St, Hartford, CT 06102-8000 | 2020-09-10 |
| 1215541933 | Molly Zarnick | Speech-Language Pathologist | 80 Seymour St, Hartford, CT 06106-3300 | 2020-09-01 |
| 1306457320 | Taylor Merrick | Physician Assistant | 80 Seymour St, Hartford, CT 06102-8000 | 2020-08-13 |
| 1538770474 | Carlyn Esposito | Registered Nurse | 80 Seymour St, Hartford, CT 06106-3315 | 2020-08-13 |
| 1679184121 | Kimberly M Davis | Nurse Anesthetist, Certified Registered | 80 Seymour St, Hartford, CT 06106-3315 | 2020-08-10 |
| 1679182109 | Elsayed Elsayed Hassan Ibrahim | Student in an Organized Health Care Education/Training Program | 80 Seymour St, Hartford, CT 06102-8000 | 2020-07-30 |
| 1780292615 | Jordan Steven Totaro | Student in an Organized Health Care Education/Training Program | 80 Seymour St, Hartford, CT 06106-3315 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144843616 | Michael Skolnick | Registered Nurse | West Grad Building, Institute of Living, 200 Retreat Ave, Hartford, CT 06102 | 2020-05-19 |
| 1942734058 | Giorgi Kveladze | Internal Medicine | 80 Seymour St. Hospitalist Devision, Hartford, CT 06102 | 2017-04-14 |
| 1902352248 | Safina Hafeez | Student in an Organized Health Care Education/Training Program | 80 Seymour Street Hartford Hospital, 3rd Floor Pathology, Hartford, CT 06102 | 2016-08-28 |
| 1154774990 | Neelam Khetpal | Internal Medicine | 80 Seymour St Bldg 502, Hartford, CT 06102 | 2016-07-17 |
| 1588073613 | Gene Pershwitz | Internal Medicine | 80 Seymour St Dept Jb704, Hartford, CT 06102 | 2014-08-02 |
| 1831503101 | Sarah Meira Benchaya | Psychiatry & Neurology | 80 Seymour Street #jb 604, Hartford, CT 06102 | 2014-06-16 |
| 1255742326 | Stephanie Felicia Alessi-larosa | Psychiatry & Neurology | 80 Seymour St. Jb 604, University of Connecticut/hartford Hospital, Hartford, CT 06102 | 2014-05-12 |
| 1619219219 | Hartford Hospital | Psychiatric Hospital | 200 Retreat St, Institute of Living, Hartford, CT 06102 | 2013-03-21 |
| 1548271141 | Pasquale F Finelli | Psychiatry & Neurology | 80 Seymour Street, Jb Suite 604, Hartford Hospital Neurology Dept., Hartford, CT 06102 | 2006-08-10 |
| 1265474340 | Gary Francis Nobert | Obstetrics & Gynecology | Hartford Hospital Ob Gyn Dept, 80 Seymour Street, Hartford, CT 06102 | 2006-06-12 |
| Find all providers in zip 06102 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
| 1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
| 1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1669009916 | Amjad O. M. Saad | Student in an Organized Health Care Education/Training Program | 80 Seymour St # 6102, Hartford, CT 06102-8000 | 2020-03-26 |
| 1497317986 | Muhammad Akrmah | Student in an Organized Health Care Education/Training Program | 250 Main St Apt 431, Hartford, CT 06106-1871 | 2019-07-03 |
| 1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
| 1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
| 1518523059 | Krishna Patel | Student in an Organized Health Care Education/Training Program | 86 Seymour St, Hartford, CT 06106-2441 | 2019-05-09 |
| 1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.