Provider Demographics
NPI:1891970588
Name:LORI L. FRITTS, MD, LLC
Entity Type:Organization
Organization Name:LORI L. FRITTS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRITTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-726-1414
Mailing Address - Street 1:3 NORTHWESTERN DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3465
Mailing Address - Country:US
Mailing Address - Phone:860-726-1414
Mailing Address - Fax:860-726-0022
Practice Address - Street 1:3 NORTHWESTERN DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3465
Practice Address - Country:US
Practice Address - Phone:860-726-1414
Practice Address - Fax:860-726-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032501208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty