| Neurological Specialist, P.c. | |
|
99 Hawley Ln Stratford CT 06614-1202 | |
| (203) 377-4788 | |
| (203) 380-0531 |
| Full Name | Neurological Specialist, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 99 Hawley Ln, Stratford, Connecticut |
| Authorized Official Name and Position | Pamela Ann Truedson (PRACTICE MANAGER) |
| Authorized Official Contact | 2032579302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurological Specialist, P.c. 2590 Main St Stratford CT 06615-5838 Ph: (120) 337-7598 | Neurological Specialist, P.c. 99 Hawley Ln Stratford CT 06614-1202 Ph: (203) 377-4788 |
| NPI Number | 1558314997 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Medicare PECOS PAC ID | 3375536469 |
|---|---|
| Medicare Enrollment ID | O20040405001601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558314997 | NPI | - | NPPES |
| 004084563 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 038663 (Connecticut) | Primary |
| Provider Name | Lisa B Webb |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063458800 PECOS PAC ID: 7012900079 Enrollment ID: I20040406000347 |
| Provider Name | Azimuddin Kazi |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1750321428 PECOS PAC ID: 0244215655 Enrollment ID: I20040621001011 |
| Provider Name | Lawrence S Beck |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992731889 PECOS PAC ID: 3971689100 Enrollment ID: I20080327000511 |
| Provider Name | Philip M Barasch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295762029 PECOS PAC ID: 7416940507 Enrollment ID: I20100423000016 |
| Provider Name | James B Butler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508802935 PECOS PAC ID: 5890989180 Enrollment ID: I20101101000353 |
| Provider Name | Pooia Fattahi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669625174 PECOS PAC ID: 1850547795 Enrollment ID: I20120809000253 |
| Provider Name | Yaniv Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710183314 PECOS PAC ID: 8325233497 Enrollment ID: I20120820000877 |
| Provider Name | Idaira Aguilar Tejedor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356758387 PECOS PAC ID: 5193019305 Enrollment ID: I20200828002006 |
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