NPI 1467527580 · live from the CMS NPI Registry
Connecticut Neurodevelopmental Services
Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology in Waterbury, CT. National Provider Identifier 1467527580, active.
NPI record
| NPI | 1467527580 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology 2084N0402X |
| Practice location | 134 Grandview Ave, Waterbury, CT 06708 |
| Practice phone | 203-755-3279 |
| Mailing address | 134 Grandview Ave, Suite# 208, Waterbury, CT 06708 |
| Enumerated | November 22, 2006 |
| Last updated | September 30, 2013 |
| Authorized official | Alok Bhargava, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Neurodevelopmental Disabilities | 2080P0008X | 030847 (CT) |
| Pediatrics | 208000000X | 030847 (CT) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 003467 (CT) |
| Nurse Practitioner, Family | 363LF0000X | 003467 (CT) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 004478 (CT) |
| Nurse Practitioner, Family | 363LF0000X | 004478 (CT) |
| Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology primary | 2084N0402X | 030847 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.