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Individual

BRUCE A. BERLOW

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
23 CLARA DR, SUITE 204, MYSTIC, CT 06355-1959
(860) 536-2995
(860) 572-0265
Mailing address
23 CLARA DR, SUITE 204, MYSTIC, CT 06355-1959
(860) 536-2995
(860) 572-0265

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036951
CT

Other

Enumeration date
12/28/2005
Last updated
07/08/2007
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