Provider Information for 1538681242
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AFRODITI PITA
Sex: Female
NPI: 1538681242
Last Updated: 2022-10-24
Certification Date: 2022-10-24
Certification Date: 2022-10-24
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538681242 | ||||||||||||||
| Enumeration Date | 2017-07-13 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-0001 United States Phone: 860-679-3170 | Fax: | ||||||||||||||
| Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-0001 United States Phone: 860-679-2000 | Fax: | ||||||||||||||
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