Individual
DR. SANJAY MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, NEUROLOGY OFFICE, FARMINGTON, CT 06030-3835
(860) 679-4888
(860) 679-1042
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
052235
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982667168
—
CT
Enumeration date
04/10/2006
Last updated
09/30/2022
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