Provider Demographics
NPI:1053477075
Name:THE HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN GENERAL AND BRADLEY
Entity Type:Organization
Organization Name:THE HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN GENERAL AND BRADLEY
Other - Org Name:THE HOSPITAL OF CENTRAL CONNECTICUT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVICAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-224-5723
Mailing Address - Street 1:100 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5011
Mailing Address - Fax:860-224-5740
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5011
Practice Address - Fax:860-224-5740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004041950OtherBEH HLTH PARTNERSHIP INPT
CT95GOtherANTHEM BEH HEALTH
CT004025243OtherSAGA OUTPT
NY00428753Medicaid
FL092132700Medicaid
CTH02258OtherOXFORD INSURANCE
CT4025243Medicaid
CT344791OtherWELLCARE MEDICARE
CTIV1010OtherHEALTHNET INSURANCE
CT004025243OtherBEH HLTH PARTNERSHIP OP
CT95GOtherBC FAMILYPLAN
CTCTGA001016OtherADV BEH HEALTH
CT4041950Medicaid
CT900050OtherCONNECTICARE INSURANCE
CT004041950OtherSAGA INPT
CO95BOtherBLUECROSS
CT004025243OtherSAGA OUTPT
CT900050OtherCONNECTICARE INSURANCE