Organization
CONNECTICUT GERIATRIC SPECIALTY GROUP, PC
Active
Organization
CONNECTICUT GERIATRIC SPECIALTY GROUP, PC
Active
Parent organization
HEBREW HOME & HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEBREW HOME & HOSPITAL
Authorized official
MR. DAVID HOULE (VICE PRESIDENT/CFO)
(860) 523-3895
Entity
Organization
Contact information
Practice address
1 ABRAHMS BOULEVARD, WEST HARTFORD, CT 06117
(860) 523-3854
(860) 523-3828
Mailing address
1 ABRAHMS BOULEVARD, WEST HARTFORD, CT 06117
(860) 523-3854
(860) 523-3828
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
05/03/2007
Last updated
09/04/2013
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