Individual
MRS. JANELLE RACHEL MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21 SOUTH RD, DERMATOLOGY, FARMINGTON, CT 06032-2482
(860) 679-4600
(860) 679-1248
Mailing address
263 FARMINGTON AVE, DEPARTMENT OF DERMATOLOGY, FARMINGTON, CT 06032-1956
(860) 679-4600
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
049883
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356529390
—
CT
Enumeration date
02/01/2008
Last updated
09/26/2022
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