Individual
DR. MARK BEITEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8 MYRTLE AVE, WESTPORT, CT 06880-3511
(203) 644-0798
Mailing address
8 MYRTLE AVE, WESTPORT, CT 06880-3511
(203) 644-0798
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002614
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060002614CT01
ANTHEM ID NUMBER
CT
Enumeration date
01/10/2007
Last updated
07/08/2007
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