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NPI 1164780342

NPI 1164780342 : LYUBA GITMAN M.D. : SHELTON, CT

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General NPI Number Information
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    NPI Number           |    1164780342
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    Entity Type          |    Individual 
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    Provider Name        |    LYUBA GITMAN M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/25/2012
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    Last Update Date     |    11/21/2025
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Provider Practice Location Address
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    Address Line         |    4 CORPORATE DR STE 280 
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    City                 |    SHELTON
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    State                |    CT
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    Zip                  |    06484-6266
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    Country              |    US
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    Telephone            |    203-245-0496
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    230 BOSTON POST RD 
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    City                 |    MADISON
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    State                |    CT
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    Zip                  |    06443-2225
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    Country              |    US
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    Telephone            |    203-245-0496
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Y00000X
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    Taxonomy Name        |    Otolaryngology Physician
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    License Number       |    72677
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    License Number State |    CT
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Taxonomy #2
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    Taxonomy Code        |    207YP0228X
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    Taxonomy Name        |    Pediatric Otolaryngology Physician
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    License Number       |    72677
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    License Number State |    CT
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Taxonomy #3
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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