Healthcare Provider Details

I. General information

NPI: 1376808865
Provider Name (Legal Business Name): SAMUEL MICHAEL ADELMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 BOSTON POST RD
WEST HAVEN CT
06516-2043
US

IV. Provider business mailing address

8 QUENTIN ST
HAMDEN CT
06517-2321
US

V. Phone/Fax

Practice location:
  • Phone: 203-508-2476
  • Fax:
Mailing address:
  • Phone: 860-377-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number008681
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: