Provider Demographics
NPI:1952431066
Name:G.P. OF HAMDEN, PC.
Entity Type:Organization
Organization Name:G.P. OF HAMDEN, PC.
Other - Org Name:GENERAL PRACTITIONERS OF HAMDEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-787-7191
Mailing Address - Street 1:1684 DIXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-3111
Mailing Address - Country:US
Mailing Address - Phone:203-787-7191
Mailing Address - Fax:203-777-8919
Practice Address - Street 1:1684 DIXWELL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3111
Practice Address - Country:US
Practice Address - Phone:203-787-7191
Practice Address - Fax:203-777-8919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service