Saad Pendergrass, Dahlia A
Saad Pendergrass, Dahlia A is an individual health care provider with primary practice located at 80 Seymour Street Hartford Hospital Psychiatry Dept, Hartford CT 06102-5037. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Saad Pendergrass, Dahlia A can be contacted via phone (860) 545-2629.Contact Information
Primary practice address
80 Seymour Street Hartford Hospital Psychiatry Dept
Hartford CT 06102-5037
Phone: (860) 545-2629
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychosomatic Medicine | 2084P0015X | 049137 | Connecticut |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 42062 | Minnesota |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 049137 | Connecticut |
Profile Details
| NPI number | 1104801745 |
|---|---|
| LBN Legal business name | Saad Pendergrass, Dahlia A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2005 |
| Last updated | Oct 22nd, 2010 - about 14 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 | 1104801745 | NPPES |
| Minnesota | Other | P00003148 | MEDICARE RAILROAD |
| Minnesota | MEDICAID | PENDING | MEDICARE RAILROAD |
| Minnesota | MEDICAID | 358640500 | MEDICARE RAILROAD |
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