Individual provider · Type 1 NPI

Laura Larrea Mantilla, MD

Student in an Organized Health Care Education/Training Program · Farmington, CT

NPI number 1952835688 Active

Practice location

263 Farmington Ave, Outpatient Pavilion, 2 West
Farmington, CT 06032-1956

Call (860) 679-4477 Map

Mailing address

263 Farmington Ave
Farmington, CT 06030-1921

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1952835688

Laura Larrea Mantilla, MD's National Provider Identifier is 1952835688, issued on Apr 19, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Farmington, CT. The record was last updated on Apr 19, 2017.