Organization
CONNECTICUT GERIATRIC PSYCHOLOGICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY W. WELLES ED.D. (PRESIDENT)
(914) 937-6174
Entity
Organization
Contact information
Practice address
112 BETSY BROWN RD, PORT CHESTER, NY 10573-2231
(914) 937-6174
(914) 937-6174
Mailing address
112 BETSY BROWN RD, PORT CHESTER, NY 10573-2231
(914) 937-6174
(914) 937-6174
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
2657
CT
Other
Enumeration date
02/17/2010
Last updated
10/27/2011
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