Individual
DR. JASON PELHAM LOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.H.P. M.H.S
Contact information
Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
Mailing address
428 COLUMBUS AVE, P.O. BOX 208059, NEW HAVEN, CT 06519-1233
(203) 503-3000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
051084
CT
207R00000X
Internal Medicine Physician
MT194913
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT194913
PA
Other
Enumeration date
05/11/2009
Last updated
03/21/2016
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