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Organization

SHORELINE PSYCHIATRIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHLEEN MARIE LAZZARINI M.D. (PRESIDENT)
(203) 871-1357
Entity
Organization

Contact information

Practice address
226 E MAIN ST, BRANFORD, CT 06405-3103
(203) 871-1357
(203) 488-5034
Mailing address
226 E MAIN ST, BRANFORD, CT 06405-3103
(203) 871-1357
(203) 488-5034

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
034237
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001342378
CT
Enumeration date
05/20/2015
Last updated
05/20/2015
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