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Organization
EASTER SEALS CONNECTICUT INC.
Active
Organization
EASTER SEALS CONNECTICUT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY M SIMON (PRESIDENT & CEO)
(860) 769-3901
Entity
Organization
Contact information
Practice address
733 SUMMER ST, STAMFORD, CT 06901-1081
(860) 242-2274
(860) 769-6564
Mailing address
120 HOLCOMB ST, HARTFORD, CT 06112-1529
(860) 242-2274
(860) 769-6564
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NULL
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004225935
—
CT
01
—
800009104CT01
BLUE CROSS/BLUE SHIELD
CT
Enumeration date
11/18/2005
Last updated
07/21/2015
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