Individual
TABITHA JOY LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 645-2049
(203) 737-1077
Mailing address
305 GEORGE ST APT 4E, NEW HAVEN, CT 06511-6682
(330) 316-5627
(203) 737-1077
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.005231RX
OH
363AM0700X
Medical Physician Assistant
Primary
4777
CT
Other
Enumeration date
09/14/2017
Last updated
10/15/2020
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