| Doctor Name: | DR. PAMELA L MANTHOUS |
| NPI Number: | 1750389524 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 032643 |
| Business Practice Address: | 18 Cedar St Grove Hill Medical Center Newington, CT - 061112647 |
| Business Phone Number: | 8606665111 |
| Business Fax Number: | 8606665153 |
| Mailing Address: | 300 Kensington Ave, Grove Hill Medical Center NEW BRITAIN |
| State: | CT |
| Postal Code: | 060513916 |
| Phone Number: | 8606665111 |
| Fax Number: | 8606665153 |
| NPI Enumeration Date: | 07/14/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 032643 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |