State of Connecticut
NPI #1902891682 in Farmington, Connecticut
Provider Information
- NPI Number
- 1902891682
- Entity Type
- Organization
- Organization Name
- State of Connecticut
- Primary Specialty
- Psychiatric Unit
- Enumeration Date
- Sep 19, 2005
- Last Updated
- Jun 17, 2009
Practice Location
- Address
- 263 FARMINGTON AVENUE
- City
- Farmington
- State
- Connecticut
- ZIP Code
- 06030-5355
- Phone
- (860) 679-2916
Authorized Official
- Name
- MR. JOHN BIANCAMANO
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (860) 679-1145
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Unit |
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