| Harbor Bridge Emotional Health, Llc | |
|
406 W Putnam Ave Greenwich CT 06830-6215 | |
| (203) 661-1054 | |
| Not Available |
| Full Name | Harbor Bridge Emotional Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 406 W Putnam Ave, Greenwich, Connecticut |
| Authorized Official Name and Position | Cheryl K Wilczak (OWNER) |
| Authorized Official Contact | 2036611054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor Bridge Emotional Health, Llc 406 W Putnam Ave Greenwich CT 06830-6215 Ph: (203) 661-1054 | Harbor Bridge Emotional Health, Llc 406 W Putnam Ave Greenwich CT 06830-6215 Ph: (203) 661-1054 |
| NPI Number | 1144420175 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 07/18/2007 |
| Medicare PECOS PAC ID | 3375644370 |
|---|---|
| Medicare Enrollment ID | O20070720000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144420175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 02766 (Connecticut) | Primary |
| Provider Name | Cheryl K Wilczak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538290432 PECOS PAC ID: 4284734203 Enrollment ID: I20070705000183 |
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