Individual
AVIJIT MITRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 MASONIC AVE, 1ST FLOOR, WALLINGFORD, CT 06492-3048
(203) 265-5720
(203) 679-5623
Mailing address
22 MASONIC AVE, 1ST FLOOR, WALLINGFORD, CT 06492-3048
(203) 265-5720
(203) 679-5623
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
039450
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001394501
—
CT
Enumeration date
10/17/2005
Last updated
01/06/2010
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