| Evan Fox Md, Llc | |
|
300 Hebron Ave Suite 107 Glastonbury CT 06033-2176 | |
| (860) 430-1150 | |
| (860) 430-1093 |
| Full Name | Evan Fox Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 300 Hebron Ave, Glastonbury, Connecticut |
| Authorized Official Name and Position | Evan Fox (OWNER) |
| Authorized Official Contact | 8604301150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Fox Md, Llc 300 Hebron Ave Suite 107 Glastonbury CT 06033-2176 Ph: (860) 430-1150 | Evan Fox Md, Llc 300 Hebron Ave Suite 107 Glastonbury CT 06033-2176 Ph: (860) 430-1150 |
| NPI Number | 1457699712 |
|---|---|
| Provider Enumeration Date | 01/22/2013 |
| Last Update Date | 01/22/2013 |
| Medicare PECOS PAC ID | 2365688728 |
|---|---|
| Medicare Enrollment ID | O20130410000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457699712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Evan Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598837429 PECOS PAC ID: 7911929906 Enrollment ID: I20051219000561 |
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