National Provider Identifier Database

BURGDORF BANK OF AMERICA HEALTH CENTER
Primary Care


Contact Information

BURGDORF BANK OF AMERICA HEALTH CENTER
131 COVENTRY ST
2ND FLOOR ADMINISTRATION
HARTFORD, CT06112-1548
Phone: 860-714-2813
Fax: 860-714-8541
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for BURGDORF BANK OF AMERICA HEALTH CENTER

NPI Number 1386085850
Legal business name
LBN
BURGDORF BANK OF AMERICA HEALTH CENTER
Authorized official BRUCE GOULD - (SITE DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 07/12/2013
Last updated 07/12/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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