Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Parent organization
STATE OF CONNECTICUT HEALTH CENTER
Other names
APRN, Orthopaedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF CONNECTICUT HEALTH CENTER
Authorized official
DENIS C LAFRENIERE MD (MEDICAL DIRECTOR)
(860) 679-7503
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, APRN, ORTHOPAEDICS, FARMINGTON, CT 06030-0001
(860) 679-7503
(860) 679-1610
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT - DOWLING SOUTH, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
CT
Other
Enumeration date
01/28/2008
Last updated
07/21/2022
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