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General NPI Number Information
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NPI Number | 1619365731
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Entity Type | Organization
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Legal Business Name | CT RECOVERY PC
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 148 EAST AVE SUITE 1 D
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City | NORWALK
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State | CT
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Zip | 06851-5721
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Country | US
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Telephone | 203-208-7120
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Fax |
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Provider Business Mailing Address
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Address Line | 148 EAST AVE SUITE 1 D
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City | NORWALK
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State | CT
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Zip | 06851-5721
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Country | US
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Telephone | 203-208-7120
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOEL BARNETT SINGER
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Credential | MD
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Telephone | 203-208-7120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 13070
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License Number State | CT
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