Healthcare Provider Details

I. General information

NPI: 1972417509
Provider Name (Legal Business Name): BRYANT ALEXANDER GARRIDO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1445 E PUTNAM AVE
OLD GREENWICH CT
06870-1379
US

IV. Provider business mailing address

506 W MAIN ST
STAMFORD CT
06902-5518
US

V. Phone/Fax

Practice location:
  • Phone: 203-622-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: