JUDITH M. MASCOLO, MD, LLC
Marriage and Family Therapists at Park Rd, Hartford, CT

License number
Connecticut 036592
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DR. JUDITH M MASCOLO M.D.
Title: OWNER
Phone: (860) 233-4600
Address
Address
639 Park Rd STE 100, Hartford, CT 06107
National Provider ID: 1043406812
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JUDITH M. MASCOLO, M.D., LLC

639 Park Rd SUITE 100, West Hartford, CT 06107

Registration:
Mar 14, 2006
State ID:
0852669
Business type:
Domestic Limited Liability Company
MEMBER:
Judith M Mascolo Md (MEMBER), 639 Park Rd SUITE 100, West Hartford, CT 06107 (Mailing)
71 White Ave, West Hartford, CT (Physical)
Agent:
Scott B Franklin,68 S Main St, West Hartford, CT (Mailing)
31 Middlefield Dr, West Hartford, CT (Physical)

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