Provider Demographics
NPI:1952419699
Name:GHIGLIA, CHRISTINE K (LNM)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:K
Last Name:GHIGLIA
Suffix:
Gender:F
Credentials:LNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40,000 DEPT 634
Mailing Address - Street 2:HARTFORD
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06151-0634
Mailing Address - Country:US
Mailing Address - Phone:860-545-7602
Mailing Address - Fax:
Practice Address - Street 1:HARTFOD HOSPITAL OB/GYN DEPT
Practice Address - Street 2:HARTFORD
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-5037
Practice Address - Country:US
Practice Address - Phone:860-545-2780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000273367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT009002734Medicaid
CTD400004148 - C00023Medicare PIN
CT009002734Medicaid