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Organization
THE INSTITUTE FOR NEURODEGENERATIVE DISORDERS
Active
Organization
THE INSTITUTE FOR NEURODEGENERATIVE DISORDERS
Active
Other names
IND
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK M MARIOTTI CPA (CFO)
(203) 401-4351
Entity
Organization
Contact information
Practice address
60 TEMPLE ST, SUITE 8B, NEW HAVEN, CT 06510-2716
(203) 401-4300
(203) 401-4304
Mailing address
60 TEMPLE ST, SUITE 8B, NEW HAVEN, CT 06510-2716
(203) 401-4300
(203) 401-4304
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
01/04/2010
Last updated
01/04/2010
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