Individual
ANTONIO BENICIO FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL CARDIOLOGY DEPT, HARTFORD, CT 06102-5037
(860) 972-4398
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
047988
CT
207RC0000X
Cardiovascular Disease Physician
Primary
047988
CT
207UN0901X
Nuclear Cardiology Physician
047988
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001479880
—
CT
Enumeration date
07/21/2009
Last updated
07/03/2013
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