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Individual

MRS. LYNETTE A. WHITE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
2340 WHITNEY AVE, HAMDEN, CT 06518-3511
(203) 248-8142
(203) 248-7764
Mailing address
579 BETHMOUR RD, BETHANY, CT 06524-3369
(203) 393-1142

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001040
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31326
CONTROLLED SUBSTANCE
CT
Enumeration date
10/17/2005
Last updated
03/07/2023
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