| Eastern Connecticut Neurology Specialist Llc | |
|
394 W Center St Manchester CT 06040-4735 | |
| (860) 647-9183 | |
| (860) 647-0582 |
| Full Name | Eastern Connecticut Neurology Specialist Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 394 W Center St, Manchester, Connecticut |
| Authorized Official Name and Position | Jessica Woodruff (OFFICE MANAGER) |
| Authorized Official Contact | 8606479183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Connecticut Neurology Specialist Llc Po Box 3262 Vernon CT 06066-2162 Ph: (860) 896-1422 | Eastern Connecticut Neurology Specialist Llc 394 W Center St Manchester CT 06040-4735 Ph: (860) 647-9183 |
| NPI Number | 1932141298 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 04/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932141298 | NPI | - | NPPES |
| C03446 | Other | CT | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 039584 (Connecticut) | Primary |
| 363L00000X | Nurse Practitioner | 005619 (Connecticut) | Secondary |
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