Organization
ASSOCIATED NEUROLOGISTS OF SOUTHERN CONNECTICUT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH COLEMAN SIEGEL M.D. (PRESIDENT)
(203) 333-1133
Entity
Organization
Contact information
Practice address
75 KINGS HIGHWAY CUTOFF, 5TH FLOOR, FAIRFIELD, CT 06824-5340
(203) 333-1133
(203) 333-3937
Mailing address
75 KINGS HIGHWAY CUTOFF, 5TH FLOOR, FAIRFIELD, CT 06824-5340
(203) 333-1133
(203) 333-3937
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
CT
2084N0400X
Neurology Physician
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4081999
—
CT
Enumeration date
09/30/2005
Last updated
08/01/2008
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