NPI 1679839229

Pediatric Psychology of Connecticut, LLC

Organisation Clinical Psychologist New Haven, CT

Practice location

Address: 413 Orange St Suite 1, New Haven, CT 06511-6424
Phone: (888) 342-6002
Fax: (347) 344-6594
Mailing address: PO Box 4098, Woodbridge, CT 06525-0298

Authorised official

Name: Mark Vincent Grudberg
Title: Member
Phone: (888) 342-6002

Registered specialties

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 3139 (CT)

Other Psychologist providers in Connecticut →

Registry record

NPI: 1679839229
Entity type: Organization
NPI issued: 9 Apr 2012
Record last updated: 9 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.