Unknown Individual – Specialist, NPI 1629029871
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
134, Grandview Avenue, West Side Hill, Waterbury, New Haven County, Connecticut, 06708, United States
SUITE 204
WATERBURY, CT 067082507
Phone: (203) 756-9288
Fax: (203) 573-7270
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 06708)
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