Provider Demographics
NPI:1558511626
Name:HARTFORD HOSPITAL
Entity Type:Organization
Organization Name:HARTFORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAUMA FELLOW
Authorized Official - Prefix:
Authorized Official - First Name:KIRANMAYI
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:203-843-7761
Mailing Address - Street 1:350 RUSSO DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1757
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 RUSSO DR
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1757
Practice Address - Country:US
Practice Address - Phone:203-843-7761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital