Connecticut Addiction Medicine, LLC
Psychiatry & Neurology, Addiction Psychiatry in Rocky Hill, CT. Organization (NPI-2).
NPI number1710312368
StatusActive
Last updated in NPPESApr 19, 2017
Details
- NPI
- 1710312368
- Entity type
- Organization (NPI-2)
- Legal business name
- Connecticut Addiction Medicine, LLC
- Organization subpart
- No
- Enumeration date
- Sep 13, 2013
- Last updated
- Apr 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0802X | Psychiatry & Neurology, Addiction Psychiatry | – | – | Yes |
| 207RA0401X | Internal Medicine, Addiction Medicine | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 364SP0808X | Clinical Nurse Specialist, Psych/Mental Health | – | – | |
| 2084A0401X | Psychiatry & Neurology, Addiction Medicine | – | – | |
| 363LA2200X | Nurse Practitioner, Adult Health | – | CT | |
| 207QA0401X | Family Medicine, Addiction Medicine | – | – | |
| 291U00000X | Clinical Medical Laboratory | CLPOL0509 | CT |
Other names
- Connecticut Addiction Medicine (Doing Business As)
Practice location
546 Cromwell AveSuite 101
Rocky Hill, CT 06067-1800
Phone 860-757-3874 · Fax 860-757-3875
Mailing address
546 Cromwell AveSuite 101
Rocky Hill, CT 06067-1800
Phone 860-757-3874 · Fax 860-757-3875
Authorized official
Tiffany Ingold
Office Manager
8609691101
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