Individual
WILLIAM A GRODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
369 GEORGETOWN RD, WESTON, CT 06883-1525
(203) 221-7908
Mailing address
369 GEORGETOWN RD, WESTON, CT 06883-1525
(203) 221-7908
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
002166
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060002166CT01
BLUE CROSS
CT
Enumeration date
04/14/2007
Last updated
07/08/2007
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