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General NPI Number Information
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NPI Number | 1083697114
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Entity Type | Individual
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Provider Name | JEFFREY HOWARD BOYD MD
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 969 W MAIN ST
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City | WATERBURY
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State | CT
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Zip | 06708-2653
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Country | US
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Telephone | 203-573-8555
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Fax | 203-597-9565
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Provider Business Mailing Address
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Address Line | 57 BETHANY WOODS RD
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City | BETHANY
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State | CT
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Zip | 06524-3103
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Country | US
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Telephone | 203-573-8555
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Fax | 203-597-9565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 019470
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License Number State | CT
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