Individual
ALISON LANE-RETICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL MEDICINE DEPT, HARTFORD, CT 06102-5037
(860) 545-2876
Mailing address
P.O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
018012
CT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
018012
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001180124
—
CT
05
—
1033103130
—
CT
Enumeration date
09/02/2005
Last updated
04/04/2012
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