Provider Demographics
NPI:1518922400
Name:GREATER HARTFORD CARDIOLOGY GROUP, P.C.
Entity type:Organization
Organization Name:GREATER HARTFORD CARDIOLOGY GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-527-6247
Mailing Address - Street 1:1000 ASYLUM AVENUE
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-527-6247
Mailing Address - Fax:860-549-7936
Practice Address - Street 1:1000 ASYLUM AVENUE
Practice Address - Street 2:SUITE 4300
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-527-6247
Practice Address - Fax:860-549-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004069373Medicaid
CT004069373Medicaid
CTC00170Medicare ID - Type Unspecified