Individual
THOMAS V DIVINAGRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 SEYMOUR ST., SUITE 409, HARTFORD, CT 06106
(860) 522-4158
(860) 524-2652
Mailing address
85 SEYMOUR ST., SUITE 409, HARTFORD, CT 06106
(860) 522-4158
(860) 524-2652
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
046129
CT
208600000X
Surgery Physician
046129
CT
2086S0129X
Vascular Surgery Physician
Primary
046129
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046129
CONNECTICARE
CT
01
—
06-1406459
PIONEER
CT
01
—
061406459
PRIVATE HEALTHCARE SYSTEMS
CT
01
—
1083859649
ANTHEM BCBS
CT
05
—
1083859649
—
CT
01
—
3V3712
HEALTH NET
CT
01
—
46286
HEALTH NEW ENGLAND
CT
01
—
508455
WELLCARE
CT
01
—
7299062
CIGNA
CT
01
—
P4028934
OXFORD
CT
Enumeration date
12/11/2008
Last updated
03/29/2011
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