Provider Demographics
NPI:1083093579
Name:BLUE HILLS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:BLUE HILLS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-852-3860
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-0052
Mailing Address - Country:US
Mailing Address - Phone:860-852-3860
Mailing Address - Fax:860-852-3860
Practice Address - Street 1:11 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3656
Practice Address - Country:US
Practice Address - Phone:860-852-3860
Practice Address - Fax:860-852-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT502822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty