Provider Demographics
NPI:1578587218
Name:MOTT, APRIL E (MD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:E
Last Name:MOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WICKHAMS FANCY
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3220
Mailing Address - Country:US
Mailing Address - Phone:860-614-7714
Mailing Address - Fax:860-352-2108
Practice Address - Street 1:1 WICKHAMS FANCY
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3220
Practice Address - Country:US
Practice Address - Phone:860-614-7714
Practice Address - Fax:860-352-2108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00122565500Medicaid
CT00122565500Medicaid
CT110007374Medicare ID - Type Unspecified