Healthcare Provider Details
I. General information
NPI: 1659299865
Provider Name (Legal Business Name): CT NEUROLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
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
- Phone: 860-783-3296
- Fax:
- Phone: 860-783-3296
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MATTHEW
SOMERVILLE
Title or Position: OWNER
Credential: MD
Phone: 860-930-4249