Individual
KARLYN MARIE MOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL MEDICINE DEPT, HARTFORD, CT 06102-5037
(860) 545-5176
Mailing address
P. O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002500
CT
363AM0700X
Medical Physician Assistant
2500
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003025224
—
CT
Enumeration date
10/15/2010
Last updated
09/10/2012
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