| Pediatric Psychology Of Connecticut, Llc | |
|
413 Orange St Suite 1 New Haven CT 06511-6424 | |
| (888) 342-6002 | |
| (347) 344-6594 |
| Full Name | Pediatric Psychology Of Connecticut, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 413 Orange St, New Haven, Connecticut |
| Authorized Official Name and Position | Mark Vincent Grudberg (MEMBER) |
| Authorized Official Contact | 8883426002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Psychology Of Connecticut, Llc Po Box 4098 Woodbridge CT 06525-0298 Ph: (888) 342-6002 | Pediatric Psychology Of Connecticut, Llc 413 Orange St Suite 1 New Haven CT 06511-6424 Ph: (888) 342-6002 |
| NPI Number | 1679839229 |
|---|---|
| Provider Enumeration Date | 04/09/2012 |
| Last Update Date | 04/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679839229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3139 (Connecticut) | Primary |
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