Mitra, Avijit
Mitra, Avijit is an sole proprietor health care provider with primary practice located at 22 Masonic Ave 1St Floor, Wallingford CT 06492-3048. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mitra, Avijit can be contacted via phone (203) 265-5720.Contact Information
Primary practice address
22 Masonic Ave 1St Floor
Wallingford CT 06492-3048
Phone: (203) 265-5720
Fax: (203) 679-5623
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 039450 | Connecticut |
Profile Details
| NPI number | 1417946179 |
|---|---|
| LBN Legal business name | Mitra, Avijit |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Jan 6th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417946179 | NPPES |
| Connecticut | MEDICAID | 001394501 |
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