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General NPI Number Information
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NPI Number | 1245503705
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Entity Type | Organization
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Legal Business Name | LJUDMIL KLJUSEV MD, LLC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 227 NAUGATUCK AVE
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City | MILFORD
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State | CT
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Zip | 06460-5540
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Country | US
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Telephone | 203-693-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 227 NAUGATUCK AVE
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City | MILFORD
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State | CT
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Zip | 06460-5540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | LJUDMIL KLJUSEV
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Credential |
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Telephone | 203-693-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 039302
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License Number State | CT
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