Healthcare Provider Details

I. General information

NPI: 1740690312
Provider Name (Legal Business Name): JOSE SILGADO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 TRIANGLE ST BLDG I-4
DANBURY CT
06810
US

IV. Provider business mailing address

12 SNIFFEN ST UNIT 1
NORWALK CT
06851-6129
US

V. Phone/Fax

Practice location:
  • Phone: 203-448-3200
  • Fax:
Mailing address:
  • Phone: 786-306-4894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003720
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: