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General NPI Number Information
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NPI Number | 1528639713
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND PSYCHOLOGICAL &NEUROPSYCHOLOGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 175 CAPITAL BLVD STE 402
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City | ROCKY HILL
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State | CT
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Zip | 06067-3914
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Country | US
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Telephone | 508-816-8787
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Fax | 860-638-4638
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Provider Business Mailing Address
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Address Line | 208 SCARBOROUGH LN
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City | MIDDLETOWN
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State | CT
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Zip | 06457-7547
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Country | US
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Telephone | 860-770-7779
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Fax | 860-638-4638
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Authorized Official
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Title or Position | OWNER
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Name | DR. JYOTHI VAYALAKKARA
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Credential | PSYD
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Telephone | 508-816-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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