Individual
MARY LEBATIQUE MINTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL TRAUMA SURGERY DEPT, HARTFORD, CT 06102-5037
(860) 545-3112
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002151
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003021516
—
CT
Enumeration date
10/17/2008
Last updated
03/26/2013
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