Organization
NEUROLOGICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY STEPHENSON (OFFICE MANAGER)
(860) 443-1891
Entity
Organization
Contact information
Practice address
350 MONTAUK AVE, NEW LONDON, CT 06320-4730
(860) 443-1891
(860) 443-2980
Mailing address
350 MONTAUK AVE, NEW LONDON, CT 06320-4730
(860) 443-1891
(860) 443-2980
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
003504
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003504
STATE LICENSE
CT
Enumeration date
06/11/2007
Last updated
08/22/2020
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