Individual
KEVIN BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.-PH.D
Contact information
Practice address
263 FARMINGTON AVENUE, FARMINGTON, CT 06030
(860) 679-4888
(860) 679-0131
Mailing address
263 FARMINGTON AVENUE, FARMINGTON, CT 06030-8082
(860) 679-4888
(860) 679-0131
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
049407
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2009
Last updated
08/14/2019
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