| Doctor Name: | CONCEPCION CABANTAC OCHOTORENA |
| NPI Number: | 1093883761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 035190 |
| Business Practice Address: | 335 Broad St Manchester, CT - 060404036 |
| Business Phone Number: | 8606433200 |
| Business Fax Number: | 8606433201 |
| Mailing Address: | 28 Bancroft Ln, SOUTH WINDSOR |
| State: | CT |
| Postal Code: | 060742463 |
| Phone Number: | 2318803894 |
| Fax Number: | 8602919506 |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 03/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 035190 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |