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Individual

MANISH TANDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL SURGERY DEPT, HARTFORD, CT 06102
(860) 545-5152
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
038032
CT
2086S0102X
Surgical Critical Care Physician
Primary
038032
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001380328
CT
Enumeration date
11/09/2005
Last updated
02/06/2013
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