Individual
TIMOTHY LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2909 BERLIN TPKE, NEWINGTON, CT 06111-4115
(860) 436-3757
Mailing address
2909 BERLIN TPKE, NEWINGTON, CT 06111-4115
(860) 436-3757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
23.003443
CT
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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