Individual
AVRAHAM Z ISSEROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
58 PINE ST, NEW CANAAN, CT 06840-5425
(203) 801-4331
(203) 801-4331
Mailing address
58 PINE ST, NEW CANAAN, CT 06840-5425
(203) 801-4331
(203) 801-4331
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
043641
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001436410
—
CT
Enumeration date
07/13/2006
Last updated
05/28/2010
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