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Individual

DR. KEITH ROEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
300 PLAZA MIDDLESEX, 3RD FLOOR, MIDDLESEX, CT 06457
(860) 347-9911
(860) 347-8120
Mailing address
300 PLAZA MIDDLESEX, 3RD FLOOR, MIDDLESEX, CT 06457
(860) 347-9911
(860) 347-8120

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1719
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00414087800
CT
01
0567535
UHC
01
060001719CT01
BLUE CROSS
01
1037571
CIGNA
01
157460
MHN
01
163070
VALUE OPTIONS
01
4257498
AETNA
CT
01
708160
MAGELLAN
01
P664410
OXFORD
Enumeration date
07/12/2006
Last updated
07/08/2007
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