Provider Information for 1972501914
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MARK D LITT PhD
Sex: Male
NPI: 1972501914
Last Updated: 2022-09-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||
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| NPI | 1972501914 | ||||||||||||||
| Enumeration Date | 2005-07-13 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 65 KANE ST PROVIDER ENROLLMENT WEST HARTFORD, CT 06119-2110 United States Phone: 860-523-6421 | Fax:860-523-3701 | ||||||||||||||
| Primary Practice Address | 10 TALCOTT NOTCH RD FARMINGTON, CT 06032-1800 United States Phone: 860-679-6700 | Fax:860-679-6736 | ||||||||||||||
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