Individual
LORI M TILDEN-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 HAZARD AVE STE 101, ENFIELD, CT 06082-5447
(860) 696-2380
Mailing address
100 HAZARD AVE STE 101, ENFIELD, CT 06082-5447
(860) 696-2380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1160
MA
363AM0700X
Medical Physician Assistant
968
CT
Other
Enumeration date
08/17/2005
Last updated
12/30/2023
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