| Nikolai Lieders, MD | |
|
Dutton Home Silver St, River Valley Services, Middletown, CT 06457 | |
| (860) 262-5358 | |
| (860) 262-5356 |
| Full Name | Nikolai Lieders |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | Dutton Home Silver St, Middletown, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396813051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 023342 (Connecticut) | Primary |
| Entity Name | Charter Oak Health Center, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992750855 PECOS PAC ID: 3870401078 Enrollment ID: O20040220000909 |
| Entity Name | State Of Connecticut |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427074426 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000365 |
| Mailing Address | Practice Location Address |
|---|---|
| Nikolai Lieders, MD Po Box 351, Dutton Home Silver St River Valley Services, Middletown, CT 06457 Ph: (860) 262-5358 | Nikolai Lieders, MD Dutton Home Silver St, River Valley Services, Middletown, CT 06457 Ph: (860) 262-5358 |
Richard M. Ketai, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 103 S Main St, Middletown, CT 06457 Phone: 860-358-8760 Fax: 860-358-8754 | |
Dr. Carlos A Cardoso, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: Silver Street, Connecticut Valley Hospital, Middletown, CT 06457 Phone: 860-262-5867 Fax: 860-262-5850 | |
Dr. Zachary Malcolm Lenane, MD, MPH Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 70 Holmes Dr, Middletown, CT 06457 Phone: 860-262-5400 | |
Jeffrey H. Gottlieb, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 28 Crescent St, Middletown, CT 06457 Phone: 860-344-6760 Fax: 860-358-4829 | |
Paul Sadowitz, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 635 Main St, Middletown, CT 06457 Phone: 860-347-6971 Fax: 860-638-6601 | |
Dr. Emily A Laurenzano, D.O. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1250 Silver St, Middletown, CT 06457 Phone: 877-577-3233 | |
Ronald E Johnson, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: Connecticut Valley Hospital, Middletown, CT 06457 Phone: 860-262-5867 Fax: 860-262-5850 |