Eugene Fantl
M.D. | Pediatrics | Male
Eugene Fantl, M.D. is a East Hartford, Connecticut based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Eugene Fantl is
99 Ash St, East Hartford, Connecticut - 06108-3226. He can be contacted on phone at
860-282-3859 and fax number 860-282-8574.
Eugene Fantl is a sole proprietor of his business.
NPI number (Unique professional ID) for Eugene Fantl is
1255337465 which was assigned by NPPES on 22 Jun, 2005 and it was last updated on 15 Jul, 2010.
Eugene Fantl license number is
019762 for Pediatrics (208000000X) in Connecticut.
Eugene Fantl is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Eugene Fantl basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Eugene Fantl |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Eugene Fantl address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 99 Ash St
East Hartford, CT, 06108-3226
United States |
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| Phone Number : | 860-282-3859 |
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| Fax Number : | 860-282-8574 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1255337465 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 22 Jun, 2005 |
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| Last Updated On : | 15 Jul, 2010 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Eugene Fantl are as mentioned. Primary taxonomy code for Eugene Fantl, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 019762 | CT |
Legacy Identifiers:
Other legacy medical identifiers of Eugene Fantl such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 1197623 | MEDICAID | CT | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 65 Kane St, Provider Enrollment
West Hartford, CT, 06119-2110
United States |
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| Phone Number : | 860-523-6421 |
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| Fax Number : | 860-523-3701 |
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Business Location:
Patients can refer following map for directions to
Eugene Fantl practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.