Individual
DR. PAMELA HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3250
(203) 503-3254
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3250
(203) 503-3254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036588
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
02/17/2006
Last updated
04/08/2010
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