Individual
DR. ANITA BOYD BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1249 BOULEVARD, WEST HARTFORD, CT 06119-1603
(860) 216-5442
Mailing address
1249 BOULEVARD, WEST HARTFORD, CT 06119-1603
(860) 216-5442
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
044628
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSP.0046239
STATE OF CT CONTROLLED SUBSTANCE REGISTRATION
CT
Enumeration date
09/17/2009
Last updated
03/07/2023
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