Provider Demographics
NPI:1730397753
Name:ATAM, RITU (MD)
Entity type:Individual
Prefix:
First Name:RITU
Middle Name:
Last Name:ATAM
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 1:330 PAXTON WAY
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3388
Mailing Address - Country:US
Mailing Address - Phone:617-368-0064
Mailing Address - Fax:
Practice Address - Street 1:350 SILAS DEANE HWY STE 100101
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1700
Practice Address - Country:US
Practice Address - Phone:617-368-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046635207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology