Individual
DR. GRAEL O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
131 COVENTRY ST, BURGDORF CLINIC - 2ND FLOOR ADMINISTRATION, HARTFORD, CT 06112-1548
(860) 714-3690
(860) 714-8683
Mailing address
131 COVENTRY ST, BURGDORF CLINIC - 2ND FLOOR ADMINISTRATION, HARTFORD, CT 06112-1548
(860) 714-3690
(860) 714-8683
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
039887
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001398876-CL
—
CT
01
—
10453102
CAQH
CT
Enumeration date
08/13/2006
Last updated
10/02/2013
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