Provider Demographics
NPI:1477534089
Name:HOSPITAL FOR SPECIAL CARE
Entity type:Organization
Organization Name:HOSPITAL FOR SPECIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-612-6309
Mailing Address - Street 1:2150 CORBIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2266
Mailing Address - Country:US
Mailing Address - Phone:860-612-6309
Mailing Address - Fax:860-832-6255
Practice Address - Street 1:2150 CORBIN AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-2266
Practice Address - Country:US
Practice Address - Phone:860-612-6309
Practice Address - Fax:860-832-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2080P0006X, 281P00000X
CT03CD261QD0000X, 261QD1600X, 261QR0400X, 261QS0112X, 282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282E00000XHospitalsLong Term Care Hospital
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial SurgeryGroup - Single Specialty
No281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00070037Medicaid
CT072004Medicare PIN