Individual
DIAMOND TYRELL-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 HARTFORD RD, MANCHESTER, CT 06040-5921
(860) 538-8942
Mailing address
858 NEW BRITAIN AVE, HARTFORD, CT 06106-3919
(860) 538-8942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048167788
CT
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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