Provider Demographics
NPI:1275599516
Name:STAMFORD PSYCHIATRIC AND GERIATRIC PSYCHIATRY ASSOCIATES
Entity Type:Organization
Organization Name:STAMFORD PSYCHIATRIC AND GERIATRIC PSYCHIATRY ASSOCIATES
Other - Org Name:STAMFORD PSYCHIATRIC AND GERIATRIC PSYCHIATRY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-323-7317
Mailing Address - Street 1:27 STRAWBERRY HILL CT
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2514
Mailing Address - Country:US
Mailing Address - Phone:203-323-7317
Mailing Address - Fax:203-978-0240
Practice Address - Street 1:27 STRAWBERRY HILL CT
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2514
Practice Address - Country:US
Practice Address - Phone:203-323-7317
Practice Address - Fax:203-978-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT234172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty