Gravino, Fonda
Gravino, Fonda is an individual health care provider with primary practice located at 99 Woodland St , Hartford CT 06105-1207. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Gravino, Fonda can be contacted via phone (860) 714-4212.Contact Information
Primary practice address
99 Woodland St
Hartford CT 06105-1207
Phone: (860) 714-4212
Fax: (860) 714-8080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 042931 | Connecticut |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 042931 | Connecticut |
Profile Details
| NPI number | 1952396020 |
|---|---|
| LBN Legal business name | Gravino, Fonda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Sep 9th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952396020 | NPPES |
| Connecticut | MEDICAID | 1952396020 |
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