Medop Behavioral Health Associates Pc | |
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 | |
(800) 370-3651 | |
(877) 515-7147 |
Full Name | Medop Behavioral Health Associates Pc |
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Speciality | Psychiatry & Neurology |
Location | 55 Hatchetts Hill Rd, Old Lyme, Connecticut |
Authorized Official Name and Position | Donna Dooley (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8003703651 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Medop Behavioral Health Associates Pc 55 Hatchetts Hill Rd Old Lyme CT 06371-1534 Ph: (800) 370-3651 | Medop Behavioral Health Associates Pc 55 Hatchetts Hill Rd Old Lyme CT 06371-1534 Ph: (800) 370-3651 |
NPI Number | 1053360677 |
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Provider Enumeration Date | 05/09/2006 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 8224047568 |
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Medicare Enrollment ID | O20060413000331 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053360677 | NPI | - | NPPES |
004262531-MD | Medicaid | CT | |
004266004-PHD | Medicaid | CT | |
004266020-NP | Medicaid | CT |
Provider Name | Marjorie A Arni |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1043263502 PECOS PAC ID: 7618986548 Enrollment ID: I20060420000304 |
Provider Name | Debora Doyle Ouellette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174579866 PECOS PAC ID: 4082624978 Enrollment ID: I20060421000008 |
Provider Name | Cora D Zembrzuski |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1124196597 PECOS PAC ID: 3375543978 Enrollment ID: I20070104000444 |
Provider Name | Nicola Giordano |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1225216880 PECOS PAC ID: 1557446929 Enrollment ID: I20090615000199 |
Provider Name | Adria Dibenedetto |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1811326671 PECOS PAC ID: 5395975122 Enrollment ID: I20140224000287 |
Provider Name | Karen Donovan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154591394 PECOS PAC ID: 1456422203 Enrollment ID: I20160607002477 |
Provider Name | Bennett Edward Moehl |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1063674893 PECOS PAC ID: 3678835931 Enrollment ID: I20180326002013 |
Provider Name | Jennifer Lou Landolt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679734123 PECOS PAC ID: 2860774064 Enrollment ID: I20180821000527 |
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