Healthcare Provider Details

I. General information

NPI: 1558420653
Provider Name (Legal Business Name): SPECTRUM PSYCHIATRIC GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WASHINGTON AVE SUITE 304
HAMDEN CT
06518
US

IV. Provider business mailing address

60 WASHINGTON AVE SUITE 304
HAMDEN CT
06518
US

V. Phone/Fax

Practice location:
  • Phone: 203-281-2890
  • Fax: 203-281-2896
Mailing address:
  • Phone: 203-281-2890
  • Fax: 203-281-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT B OSTROFF
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 203-281-2897