Karen Dettmer
Adolescent Medicine
20 Felicity Ln
Torrington
, Connecticut 06790-6101
Karen Dettmer
Adolescent Medicine
20 Felicity Ln
Torrington
, Connecticut 06790-6101
(860) 496-0450
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Karen Dettmer
- 20 Felicity Ln
- Torrington, CT
- Zip : 06790-6101
- Phone : (860) 496-0450
Second Address
- Karen Dettmer
- 20 Felicity Ln
- Torrington, CT
- Zip : 06790-6101
- Fax : (860) 489-4412
- Phone : (860) 489-4144
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 038261 | CT |
National Provider Identifier
| NPI | 1154363430 |
|---|---|
| Provider Name | Karen Dettmer |
| First Address | Torrington, CT 06790-6101 |
| Second Address | Torrington, CT 06790-6101 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2006 |
| Last Update Date | 03/03/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 001382613 | (05) | CT |
| G82218 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.