Individual
BETHANY TERESA WHITNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
85 SEYMOUR ST STE 1000, HARTFORD, CT 06106-5564
(860) 246-2571
Mailing address
30 WATERCHASE DR, ROCKY HILL, CT 06067-2110
(413) 446-7084
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4575
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346809589
—
CT
Enumeration date
06/11/2019
Last updated
12/03/2021
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