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General NPI Number Information
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NPI Number | 1942480074
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Entity Type | Organization
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Legal Business Name | NEIL D. STEIN, MD, LLC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 12 N MAIN ST SUITE 110
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1932
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Country | US
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Telephone | 860-232-2626
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Fax | 860-233-5407
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Provider Business Mailing Address
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Address Line | 12 N MAIN ST SUITE 110
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1932
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Country | US
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Telephone | 860-232-2626
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Fax | 860-233-5407
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Authorized Official
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Title or Position | OWNER
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Name | DR. NEIL DAVID STEIN
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Credential | MD
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Telephone | 860-232-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 027253
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License Number State | CT
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