| Hebrew Home And Hospital, Inc | |
|
1 Abrahms Blvd West Hartford CT 06117-1508 | |
| (860) 523-3800 | |
| (860) 523-3949 |
| Full Name | Hebrew Home And Hospital, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Abrahms Blvd, West Hartford, Connecticut |
| Authorized Official Name and Position | David A Houle (EXECUTIVE VICE PRESIDENT & CFO) |
| Authorized Official Contact | 8605233895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hebrew Home And Hospital, Inc 1 Abrahms Blvd West Hartford CT 06117-1508 Ph: (860) 523-3800 | Hebrew Home And Hospital, Inc 1 Abrahms Blvd West Hartford CT 06117-1508 Ph: (860) 523-3800 |
| NPI Number | 1558301689 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 1759279961 |
|---|---|
| Medicare Enrollment ID | O20040309000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558301689 | NPI | - | NPPES |
| 004215457 | Medicaid | CT | |
| 047785 | Other | CT | EVERCARE |
| 00000804 | Other | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Harold E Sandals |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659348134 PECOS PAC ID: 3577656321 Enrollment ID: I20070910000765 |
| Provider Name | Ava Pannullo |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1578545620 PECOS PAC ID: 2769551464 Enrollment ID: I20080521000516 |
| Provider Name | Heidi S Haller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629249081 PECOS PAC ID: 3072682608 Enrollment ID: I20080521000741 |
| Provider Name | Barbara B Baron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114083078 PECOS PAC ID: 1557432622 Enrollment ID: I20080617000400 |
| Provider Name | Alexander Mbewe |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1811053812 PECOS PAC ID: 3870665243 Enrollment ID: I20080630000147 |
| Provider Name | Mark R Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942267265 PECOS PAC ID: 4981653847 Enrollment ID: I20090319000375 |
| Provider Name | Lynne M Todd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144431602 PECOS PAC ID: 9830275759 Enrollment ID: I20110819000102 |
| Provider Name | Patricia L Almeida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437428141 PECOS PAC ID: 2567622731 Enrollment ID: I20120326000428 |
| Provider Name | Melissa C Rusate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427301753 PECOS PAC ID: 2860646684 Enrollment ID: I20130202000041 |
| Provider Name | Misbahul H Siddiqi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396083481 PECOS PAC ID: 4587807375 Enrollment ID: I20130827000068 |
| Provider Name | Tracey Urso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356772107 PECOS PAC ID: 8224268446 Enrollment ID: I20140307000382 |
| Provider Name | Viktoriya Anatolievna Stork |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891278529 PECOS PAC ID: 5597019224 Enrollment ID: I20181116000625 |
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