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General NPI Number Information
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NPI Number | 1558314997
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL SPECIALIST, P.C.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 99 HAWLEY LN
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City | STRATFORD
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State | CT
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Zip | 06614-1202
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Country | US
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Telephone | 203-377-4788
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Fax | 203-380-0531
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Provider Business Mailing Address
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Address Line | 2590 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06615-5838
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Country | US
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Telephone | 120-337-7598
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Fax | 120-338-0053
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | PAMELA ANN TRUEDSON
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Credential |
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Telephone | 203-257-9302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 038663
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License Number State | CT
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