Healthcare Provider Details
I. General information
NPI: 1306054838
Provider Name (Legal Business Name): NAVNIT S. MITTER MSC, MS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 WATSON BLVD
STRATFORD CT
06615-7127
US
IV. Provider business mailing address
77 BROOKFIELD RD
SEYMOUR CT
06483-2377
US
V. Phone/Fax
- Phone: 203-381-4013
- Fax: 203-380-4554
- Phone: 203-888-5498
- Fax: 717-828-6651
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170100000X |
| Taxonomy | Ph.D. Medical Genetics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: