Provider Demographics
NPI:1407270556
Name:KIMBERLEE J. SASS, PH.D., P.C.
Entity Type:Organization
Organization Name:KIMBERLEE J. SASS, PH.D., P.C.
Other - Org Name:CONNECTICUT NEUROPSYCHOLOGY, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SASS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-281-3060
Mailing Address - Street 1:1040 MOUNT CARMEL AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1608
Mailing Address - Country:US
Mailing Address - Phone:203-281-3060
Mailing Address - Fax:
Practice Address - Street 1:291 WHITNEY AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3724
Practice Address - Country:US
Practice Address - Phone:203-281-3060
Practice Address - Fax:866-596-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT01234103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty