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General NPI Number Information
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NPI Number | 1891833729
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Entity Type | Individual
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Provider Name | ANDREW BOHDAN PLESHKEVICH PHD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 GRAND ST COUNSELING CENTER
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2016
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Country | US
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Telephone | 860-224-5267
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Fax | 860-224-5752
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Provider Business Mailing Address
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Address Line | 50 GRISWOLD STREET COUNSELING CENTER
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City | NEW BRITAIN
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State | CT
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Zip | 06050
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Country | US
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Telephone | 860-224-5267
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Fax | 860-224-5752
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002753
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License Number State | CT
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