Organization
MANCHESTER MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD BOISVERT (SR VICE PRESIDENT)
(860) 263-4190
Entity
Organization
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4188
(860) 646-1222
Mailing address
1290 SILAS DEANE HWY STE 102, WETHERSFIELD, CT 06109-4337
(860) 972-3075
(860) 972-7040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
273R00000X
Psychiatric Hospital Unit
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/14/2025
Last updated
04/20/2026
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