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Individual

DR. LAVANYA JITENDRANATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL DEPT OF MEDICINE INFECTIOUS DISEASES, HARTFORD, CT 06102-8000
(860) 358-6878
(860) 358-6412
Mailing address
80 S MAIN ST, MIDDLETOWN, CT 06457-3648
(860) 358-6878
(860) 358-6412

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
045367
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001453670
CT
01
440000193
MEDICARE PROV #
CT
Enumeration date
05/24/2006
Last updated
03/04/2020
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