Individual
JONATHAN MITTELMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
534 SAYBROOK RD, MIDDLETOWN, CT 06457-4754
(860) 344-6394
(860) 344-6748
Mailing address
534 SAYBROOK RD, MIDDLETOWN, CT 06457-4754
(860) 344-6394
(860) 344-6748
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
037352
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037352
CT LIC #
CT
Enumeration date
05/31/2006
Last updated
07/08/2007
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