Healthcare Provider Details

I. General information

NPI: 1316850563
Provider Name (Legal Business Name): NORTHLINE PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 FLANDERS RD STE B1
NIANTIC CT
06357-1211
US

IV. Provider business mailing address

170 FLANDERS RD STE B1
NIANTIC CT
06357-1211
US

V. Phone/Fax

Practice location:
  • Phone: 860-385-6547
  • Fax: 860-807-1613
Mailing address:
  • Phone: 860-385-6547
  • Fax: 860-807-1613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TUVIA BREUER
Title or Position: PRESIDENT
Credential: DO
Phone: 860-385-6547