Organization
CT COMPREHENSIVE NEUROLOGIC MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSALIE G. MEDNICK (OFFICE MANAGER)
(203) 234-1993
Entity
Organization
Contact information
Practice address
2 BROADWAY, NORTH HAVEN, CT 06473-2349
(203) 234-1993
(203) 234-7147
Mailing address
2 BROADWAY, NORTH HAVEN, CT 06473-2349
(203) 234-1993
(203) 234-7147
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
037501
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010037501CT02
ANTHEM
CT
01
—
0Q3637
HEALTHNET
CT
01
—
317063
WELLCARE
CT
01
—
3223587
AETNA
CT
01
—
772945
CONNECTICARE
CT
01
—
9794136003
CIGNA
CT
01
—
P2491200
OXFORD
CT
Enumeration date
09/21/2006
Last updated
06/21/2010
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