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General NPI Number Information
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NPI Number | 1558859132
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Entity Type | Individual
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Provider Name | THERESA HELENE MEOTTI MD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2018
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 4 SHAWS CV STE 103
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City | NEW LONDON
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State | CT
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Zip | 06320-4956
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Country | US
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Telephone | 860-443-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HWY HHC-CVO
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4337
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Country | US
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Telephone | 860-443-3778
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 80176
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License Number State | CT
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