Provider Demographics
NPI:1609183516
Name:HARTFORD HOSPITAL
Entity Type:Organization
Organization Name:HARTFORD HOSPITAL
Other - Org Name:HARTFORD HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-332-1848
Mailing Address - Street 1:177 WHITE PLAINS RD APT 35A
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5554
Mailing Address - Country:US
Mailing Address - Phone:914-332-1848
Mailing Address - Fax:
Practice Address - Street 1:177 WHITE PLAINS RD APT 35A
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5554
Practice Address - Country:US
Practice Address - Phone:914-332-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048275282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital