Provider Information for 1164955787
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LITTY MATHEWS M.D
Sex: Female
NPI: 1164955787
Last Updated: 2023-08-22
Certification Date: 2023-08-22
Certification Date: 2023-08-22
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164955787 | ||||||||||||
| Enumeration Date | 2017-04-10 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-8082 United States Phone: 860-523-6436 | Fax: | ||||||||||||
| Primary Practice Address | 65 KANE ST WEST HARTFORD, CT 06119-2110 United States Phone: 860-523-6436 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 2601 OCEAN PKWY | ||||||||||||
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