Provider Demographics
NPI:1740608769
Name:HART, JESSICA MASIERO (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MASIERO
Last Name:HART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 JEFFERSON ST STE 625
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2602
Mailing Address - Country:US
Mailing Address - Phone:860-972-2884
Mailing Address - Fax:860-545-3396
Practice Address - Street 1:85 JEFFERSON ST STE 625
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2602
Practice Address - Country:US
Practice Address - Phone:860-972-2884
Practice Address - Fax:860-545-3396
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT67044207VX0000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics