Healthcare Provider Details

I. General information

NPI: 1598021123
Provider Name (Legal Business Name): ELISABETH H FRIMBERGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 BAILEYVILLE RD
MIDDLEFIELD CT
06455-1014
US

IV. Provider business mailing address

255 BAILEYVILLE RD
MIDDLEFIELD CT
06455-1014
US

V. Phone/Fax

Practice location:
  • Phone: 860-416-0078
  • Fax:
Mailing address:
  • Phone: 860-416-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number033212
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: