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Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Parent organization
STATE OF CONNECTICUT HEALTH CENTER
Other names
Pediatric Hematology/Oncology
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF CONNECTICUT HEALTH CENTER
Authorized official
DENIS C LAFRENIERE MD (MEDICAL DIRECTOR)
(860) 679-7503
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, PEDIATRIC HEMATOLOGY/ONCOLOTY, FARMINGTON, CT 06030-0001
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT - PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
CT
Other
Enumeration date
12/27/2007
Last updated
07/21/2022
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