| NPI | 1063785814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAH NAWAZ Medical Director 203-270-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 039250) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CT 039250) |
| 101YP2500X Counselor, Professional (Licence: CT 039250) | |
| 101YM0800X Counselor, Mental Health (Licence: CT 039250) | |
| 104100000X Social Worker (Licence: CT 039250) | |
| 1041C0700X Social Worker, Clinical (Licence: CT 039250) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 039250) | |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2014-11-17 |