Organization
TELEBUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L. SIMON M.D., J.D. (CHIEF MANAGING OFFICER)
(860) 230-3294
Entity
Organization
Contact information
Practice address
2 LEDGEBROOK DR FL 2, MANSFIELD CENTER, CT 06250-1682
(860) 230-3294
Mailing address
PO BOX 618, MANSFIELD CENTER, CT 06250-0618
(860) 230-3294
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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