HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC (NPI# 1790338978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790338978 |
| Entity Type | Organization |
| Organization Name | HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS LLC |
| Practice Address |
455 Lewis Ave Ste 210 Meriden CT 06451-2121 |
| Mailing Address |
1290 Silas Deane Hwy Wethersfield CT 06109-4337 |
| Practice Telephone | 2032381241 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MARK BANCROFT VYE (VP ADMINISTRATION) |
| Authorized Official Telephone | 8609727858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367068 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 85 Poheganut Drive, Suite 3, Groton, CT 06340-3252 | 2020-02-10 |
| 1205489465 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 100 Hazard Ave Ste 206, Enfield, CT 06082-5447 | 2019-07-17 |
| 1629621891 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 65 Memorial Rd Ste 430, West Hartford, CT 06107-4220 | 2019-07-17 |
| 1750934998 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 330 Western Blvd, Glastonbury, CT 06033-4383 | 2019-07-17 |
| 1750934048 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | 2019-07-17 |
| 1023584216 | Hartford Healthcare Medical Group Specialists LLC | Transplant Surgery | 85 Seymour St Ste 415, Hartford, CT 06106-5523 | 2018-10-16 |
| Street Address |
455 LEWIS AVE STE 210 |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| Find all providers in zip 06451 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528246568 | Dr Jack Herrle Od | Durable Medical Equipment & Medical Supplies | 130 East Main St, Meriden, CT 06450 | 2008-02-01 |
| 1205961877 | Graeber' Medical and Nutri Supply | Durable Medical Equipment & Medical Supplies | 172 West Main St, Meriden, CT 06451-4104 | 2007-02-22 |
| 1508960436 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 153 Broad St, Meriden, CT 06450-6550 | 2006-09-12 |
| 1629172549 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 540 W Main St, Meriden, CT 06451-2710 | 2006-09-12 |
| 1467556365 | Connecticut Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 839 E Main St, Meriden, CT 06450-6006 | 2006-09-12 |
| 1528076189 | Graeber's Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 172 W Main St, Meriden, CT 06451-4104 | 2006-08-03 |
| 1528080124 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 474 Chamberlain Hwy, Meriden, CT 06451-1818 | 2006-07-24 |
| 1487686358 | Stop and Shop Supermarket Co LLC | Durable Medical Equipment & Medical Supplies | 485 Broad St, Meriden, CT 06450-5801 | 2006-07-07 |
| 1174563902 | New England Orthotic & Prosthetic Systems, LLC | Durable Medical Equipment & Medical Supplies | 61 Pomeroy Avenue, Building 2, Meriden, CT 06450-7101 | 2006-06-08 |
| 1871953471 | Graeber's Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 172 West Main St, Meriden, CT 06451-4104 | 2016-02-25 |
| Find all providers in MERIDEN | ||||
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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.