Individual
BEVERLY GREENSPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, NEUROLOGY, FARMINGTON, CT 06030-0001
(860) 679-4888
(860) 679-1042
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT OFFICE, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
030823
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001308239
—
CT
Enumeration date
06/17/2005
Last updated
07/05/2012
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