Provider Demographics
NPI:1164975884
Name:HARTFIELD, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HARTFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5238
Mailing Address - Country:US
Mailing Address - Phone:860-614-7988
Mailing Address - Fax:
Practice Address - Street 1:875 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-5238
Practice Address - Country:US
Practice Address - Phone:860-614-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst