| Robert A Grillo Jr, MD | |
|
1 Wahoo Ave, Groton, CT 06349-2324 | |
| (860) 694-4966 | |
| (860) 694-3388 |
| Full Name | Robert A Grillo Jr |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1 Wahoo Ave, Groton, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770565566 | NPI | - | NPPES |
| 001264887 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 26488 (Connecticut) | Primary |
| Entity Name | Windham Community Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023191467 PECOS PAC ID: 2961309059 Enrollment ID: O20031217000231 |
| Entity Name | The William W Backus Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467517235 PECOS PAC ID: 0749170645 Enrollment ID: O20040316000739 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert A Grillo Jr, MD 1 Wahoo Ave, Groton, CT 06349-2324 Ph: (860) 694-4966 | Robert A Grillo Jr, MD 1 Wahoo Ave, Groton, CT 06349-2324 Ph: (860) 694-4966 |
Dr. Julia Jacobs, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1 Wahoo Ave, Groton, CT 06349 Phone: 860-694-4496 | |
David Baird Lobozzo, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1 Wahoo Ave, Groton, CT 06349 Phone: 860-694-4966 | |
Dr. Douglas Charles Mcadams, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1 Wahoo Ave, Groton, CT 06349 Phone: 860-694-4123 | |
Mark William Mittauer, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: Rte 12 Bldg 449, Groton, CT 06349 Phone: 860-694-2377 Fax: 860-694-2590 | |
Dr. Kimberly C. Riquelme, D.O. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1353 Gold Star Hwy, Groton, CT 06340 Phone: 860-449-9947 | |
Dr. Ismail Yahyazade, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: Route 12 Bldg 449, Naval Ambulatory Care Center Attn Professional Affairs, Groton, CT 06349 Phone: 860-694-2377 Fax: 860-694-2590 |