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NPI Code Detail

MEDICARE: JAMES LOGAN

MEDICARE: JAMES LOGAN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1932043452
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES LOGAN
Provider Business Mailing Address
First Line : 54 WOODBRIDGE RD
Second Line :
City : GLASTONBURY
State : CT
Zip : 06033-2925
Country : US
Telephone Number : 860-922-0552
Fax Number :
Provider Business Practice Location Address
First Line : 77 HARTLAND ST STE 108
Second Line :
City : EAST HARTFORD
State : CT
Zip : 06108-3259
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ JAMES LOGAN ” Practice Location

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