Healthcare Provider Details

I. General information

NPI: 1659299865
Provider Name (Legal Business Name): CT NEUROLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 HAZARD AVE FL 1
ENFIELD CT
06082-4520
US

IV. Provider business mailing address

170 HAZARD AVE FL 1
ENFIELD CT
06082-4520
US

V. Phone/Fax

Practice location:
  • Phone: 860-783-3296
  • Fax:
Mailing address:
  • Phone: 860-783-3296
  • Fax: 860-763-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MATTHEW SOMERVILLE
Title or Position: OWNER
Credential: MD
Phone: 860-930-4249