Organization
MENTAGEN ADVANCED BEHAVIORAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD SHAMSI MD (OWNER)
(860) 338-4864
Entity
Organization
Contact information
Practice address
74 NEW LONDON TPKE, SUITE 5, GLASTONBURY, CT 06033-4204
(860) 338-4864
Mailing address
74 NEW LONDON TPKE, SUITE 5, GLASTONBURY, CT 06033-4204
(860) 338-4864
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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