| Waterbury Neurology Llc | |
|
1625 Straits Turnpike Suite 307 Middlebury CT 06762-1836 | |
| (203) 758-8995 | |
| (203) 758-2571 |
| Full Name | Waterbury Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1625 Straits Turnpike, Middlebury, Connecticut |
| Authorized Official Name and Position | Pooia Fattahi (PARTNER) |
| Authorized Official Contact | 2037588995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterbury Neurology Llc 1625 Straits Turnpike Suite 307 Middlebury CT 06762-1836 Ph: (203) 758-8995 | Waterbury Neurology Llc 1625 Straits Turnpike Suite 307 Middlebury CT 06762-1836 Ph: (203) 758-8995 |
| NPI Number | 1255378501 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 04/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255378501 | NPI | - | NPPES |
| 1284603 | Medicaid | CT | |
| 1361138 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Connecticut) | Primary |
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