Organization
CLINISANITAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN E MURILLO (CREDENTIALING SPECIALIST)
(786) 408-8502
Entity
Organization
Contact information
Practice address
175 MAIN ST, HARTFORD, CT 06106-1818
(844) 307-4827
Mailing address
175 MAIN ST, HARTFORD, CT 06106-1818
(844) 307-4827
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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