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1124026398
DIANE L WHITAKER
FARMINGTON, CT
NPI
1124026398
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: CT 032383)
Enumeration Date
2005-07-12
Last Update Date
2022-07-11
Business Address
-- DIANE L WHITAKER MD
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-4600
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Mailing Address
-- DIANE L WHITAKER MD
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503
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