Individual
DR. GEOFFREY M SCHNIRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
100 PERKINS FARM DR STE 102, MYSTIC, CT 06355-4041
(860) 870-6385
Mailing address
100 PERKINS FARM DRIVE, SUITE 102, MYSTIC, CT 06355
(401) 486-4374
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS00813
RI
103G00000X
Clinical Neuropsychologist
Primary
—
CT
103TC0700X
Clinical Psychologist
PS00813
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003971
CT LIC
CT
01
—
26685-1
RI BCBS PROVIDER ID
RI
01
—
411522
BLUE CHIP PROVIDER ID
RI
Enumeration date
06/20/2005
Last updated
07/19/2022
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