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555 Highland Ave Ste 1 Cheshire CT 06410-2255 | |
| (203) 437-2161 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 555 Highland Ave Ste 1, Cheshire, Connecticut |
| Authorized Official Name and Position | Laurie Fistola (ACCESS MANAGER) |
| Authorized Official Contact | 2032176601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
408 Highland Ave Cheshire CT 06410-2525 Ph: () - | 555 Highland Ave Ste 1 Cheshire CT 06410-2255 Ph: (203) 437-2161 |
| NPI Number | 1841552320 |
|---|---|
| Provider Enumeration Date | 06/12/2012 |
| Last Update Date | 02/24/2024 |
| Certification Date | 02/24/2024 |
| Medicare PECOS PAC ID | 6608309208 |
|---|---|
| Medicare Enrollment ID | O20241104000828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841552320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001297 (Connecticut) | Primary |
| Provider Name | Jeffrey Farley Kochiss |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1962704429 PECOS PAC ID: 8325571920 Enrollment ID: I20241104001686 |
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