Individual
TABITHA FORTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
23 HOYT ST, SUITE #4, STAMFORD, CT 06905-5604
(203) 674-0774
(203) 674-0766
Mailing address
23 HOYT ST, SUITE #4, STAMFORD, CT 06905-5604
(203) 674-0774
(203) 674-0766
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037894
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008036735
—
CT
Enumeration date
08/10/2005
Last updated
02/24/2017
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