Individual
DR. BRUCE A. BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
674 PROSPECT AVE, HARTFORD, CT 06105-4288
(860) 233-6228
(860) 233-2371
Mailing address
95 PUNCH BROOK RD, BURLINGTON, CT 06013-1814
(860) 673-5949
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
000-998
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4061628
—
CT
Enumeration date
07/22/2006
Last updated
07/08/2007
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