Individual
DR. JAIME IMITOLA HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4888
(860) 679-0131
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8031
(860) 679-4888
(860) 679-0131
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
063204
CT
2084N0400X
Neurology Physician
35122346
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0093556
—
OH
Enumeration date
06/12/2008
Last updated
09/26/2022
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