Organization
CT COMPREHENSIVE NEUROLOGIC MANAGEMENT, LLC
Active
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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