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NPI Code Detail

MEDICARE: DR. BRENDA COYLE PH.D.

MEDICARE:  DR. BRENDA  COYLE  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist002258CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060002258CT02OTHERCTANTHEM BCBS

General Provider Information

NPI Number : 1477681278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENDA COYLE PH.D.
Provider Business Mailing Address
First Line : 32 PHEASANT HILL RD
Second Line :
City : COLLINSVILLE
State : CT
Zip : 06019-3041
Country : US
Telephone Number : 860-335-5844
Fax Number :
Provider Business Practice Location Address
First Line : 50 ALBANY TPKE
Second Line : SUITE 5023
City : CANTON
State : CT
Zip : 06019-2516
Country : US
Telephone Number : 860-335-5844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/08/2007

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Directions to “ DR. BRENDA COYLE PH.D.” Practice Location

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