NPI 1922887165

Jeramie Jason Mota

Practitioner Driver Cheshire, CT

Practice location

Address: 55 Charter Oak Dr, Cheshire, CT 06410-1050
Phone: (203) 996-2558
Mailing address: 672 Queen St, Southington, CT 06489-1540

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 209109538 (CT)

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Registry record

NPI: 1922887165
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Sep 2023
Record last updated: 27 Sep 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.