Provider Demographics
NPI:1821050915
Name:HOLZMAN, STEPHEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:HOLZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:98 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3621
Mailing Address - Country:US
Mailing Address - Phone:860-657-8868
Mailing Address - Fax:860-657-8802
Practice Address - Street 1:200 OAK ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2320
Practice Address - Country:US
Practice Address - Phone:860-657-8868
Practice Address - Fax:860-657-8802
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0239582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD02638Medicare UPIN