Provider Demographics
NPI:1518620400
Name:BYROM, ROBERT ARTHUR JR
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:BYROM
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LONG LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4005
Mailing Address - Country:US
Mailing Address - Phone:619-730-9974
Mailing Address - Fax:
Practice Address - Street 1:1 LONG LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4005
Practice Address - Country:US
Practice Address - Phone:619-730-9974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty