| 567 Vauxhall, Llc | |
|
567 Vauxhall Street Ext Ste 126 Waterford CT 06385-4332 | |
| (860) 444-0503 | |
| Not Available |
| Full Name | 567 Vauxhall, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 567 Vauxhall Street Ext Ste 126, Waterford, Connecticut |
| Authorized Official Name and Position | Martin Jude Maloney (PSYCHIATRIST) |
| Authorized Official Contact | 8604440503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 567 Vauxhall, Llc 567 Vauxhall Street Ext Ste 126 Waterford CT 06385-4332 Ph: (860) 444-0503 | 567 Vauxhall, Llc 567 Vauxhall Street Ext Ste 126 Waterford CT 06385-4332 Ph: (860) 444-0503 |
| NPI Number | 1598198038 |
|---|---|
| Provider Enumeration Date | 08/20/2013 |
| Last Update Date | 08/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598198038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | CT 000159 (Connecticut) | Primary |
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