| Neuropsychiatry Mso Llc | |
|
5 Research Dr Shelton CT 06484-6232 | |
| (203) 567-5264 | |
| Not Available |
| Full Name | Neuropsychiatry Mso Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5 Research Dr, Shelton, Connecticut |
| Authorized Official Name and Position | Manoj Wadhwani (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2032607972 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuropsychiatry Mso Llc 5 Research Dr Shelton CT 06484-6232 Ph: (203) 567-5264 | Neuropsychiatry Mso Llc 5 Research Dr Shelton CT 06484-6232 Ph: (203) 567-5264 |
| NPI Number | 1407498603 |
|---|---|
| Provider Enumeration Date | 10/09/2019 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 5193157816 |
|---|---|
| Medicare Enrollment ID | O20191119002024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407498603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Carlos Alberto Rueda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366490195 PECOS PAC ID: 6103807607 Enrollment ID: I20200413000729 |
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