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General NPI Number Information
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NPI Number | 1568457893
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Entity Type | Individual
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Provider Name | MONICA SRODON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 71 HAYNES ST
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City | MANCHESTER
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State | CT
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Zip | 06040-4131
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Country | US
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Telephone | 860-647-6487
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Fax | 860-647-6447
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | NEW HAVEN
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State | CT
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Zip | 06501-0206
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Country | US
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Telephone | 203-397-8000
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Fax | 203-389-1540
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 046164
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 046164
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License Number State | CT
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