Individual
KRISTA E MATSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6343
Mailing address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 928-6541
(860) 963-6343
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
040939
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001409392
—
CT
Enumeration date
02/20/2006
Last updated
11/10/2011
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