Provider Demographics
NPI:1336432517
Name:INGRASSIA, JOSEPH JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAMES
Last Name:INGRASSIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST STE 1022
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5530
Mailing Address - Country:US
Mailing Address - Phone:860-972-3570
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR ST STE 1022
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-972-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297796207R00000X, 207RC0000X
CT056497207R00000X
CT56497207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT51-0173264OtherFEDERAL EMPLOYER IDENTIFICATION NUMBER