Provider Demographics
NPI:1568264091
Name:PITNEY, ETHAN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ETHAN
Middle Name:JAMES
Last Name:PITNEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 CLARK HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST HADDAM
Mailing Address - State:CT
Mailing Address - Zip Code:06423-1548
Mailing Address - Country:US
Mailing Address - Phone:860-227-4348
Mailing Address - Fax:
Practice Address - Street 1:92 CLARK HILL RD
Practice Address - Street 2:
Practice Address - City:EAST HADDAM
Practice Address - State:CT
Practice Address - Zip Code:06423-1548
Practice Address - Country:US
Practice Address - Phone:860-227-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program