Healthcare Provider Details

I. General information

NPI: 1871591511
Provider Name (Legal Business Name): HERBERT H. SCHETTLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 LITCHFIELD ST SUITE 102
TORRINGTON CT
06790-6669
US

IV. Provider business mailing address

538 LITCHFIELD ST SUITE 102
TORRINGTON CT
06790-6669
US

V. Phone/Fax

Practice location:
  • Phone: 860-496-8990
  • Fax: 860-496-7301
Mailing address:
  • Phone: 860-496-8990
  • Fax: 860-496-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number017353
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: