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NPI Code Detail

MEDICARE: DR. EUGENE B PIASETSKY PH.D.

MEDICARE: DR. EUGENE B PIASETSKY 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
1103G00000XClinical Neuropsychologist01445CT
2103G00000XClinical Neuropsychologist07636NY

General Provider Information

NPI Number : 1942424189
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUGENE B PIASETSKY PH.D.
Provider Business Mailing Address
First Line : 2558 WHITNEY AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3046
Country : US
Telephone Number : 203-230-2199
Fax Number : 203-230-2242
Provider Business Practice Location Address
First Line : 2558 WHITNEY AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3046
Country : US
Telephone Number : 203-230-2199
Fax Number : 203-230-2242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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