Organization
DR OVANESSIAN TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON OVANESSAIN M.D. (PHYSICIAN/SURGEON)
(845) 548-6073
Entity
Organization
Contact information
Practice address
20 CHURCH HILL RD, NEWTOWN, CT 06470-1657
(203) 304-9599
Mailing address
20 CHURCH HILL RD, NEWTOWN, CT 06470-1657
(203) 304-9559
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
042079
CT
305R00000X
Preferred Provider Organization
042079
CT
Other
Enumeration date
05/01/2010
Last updated
04/04/2013
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