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General NPI Number Information
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NPI Number | 1902394208
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Entity Type | Organization
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Legal Business Name | AARON J. ROBERTO, M.D., L.L.C.
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 28 1ST ST
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City | STAMFORD
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State | CT
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Zip | 06905-5101
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Country | US
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Telephone | 203-747-8728
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Fax |
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Provider Business Mailing Address
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Address Line | 38 HERITAGE DR
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City | EASTON
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State | CT
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Zip | 06612-2241
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Country | US
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Telephone | 203-747-0728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AARON JESSE ROBERTO
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Credential | M.D.
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Telephone | 203-747-8728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 56428
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 56428
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License Number State | CT
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