Individual
EDMUND TAMAS TAKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 S MAIN ST STE 201, MIDDLETOWN, CT 06457-3649
(860) 358-6418
Mailing address
90 S MAIN ST STE 201, MIDDLETOWN, CT 06457-3649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NA
CT
Other
Enumeration date
04/02/2026
Last updated
04/08/2026
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