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Organization

EVOLVE BRAIN HEALTH LLC

Active
Other names
Evolve
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS JOSEPH KNIGHTLY JR. MD (OWNER)
(978) 857-1424
Entity
Organization

Contact information

Practice address
1055 SUMMER ST, STAMFORD, CT 06905-5527
(203) 504-9758
(203) 504-9758
Mailing address
1055 SUMMER ST STE 2, STAMFORD, CT 06905-5527
(203) 504-9758
(203) 547-4914

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
07/28/2022
Last updated
09/30/2024
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