Provider Demographics
NPI:1851792741
Name:JEFFREY H. BOYD, M.D.,AND ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:JEFFREY H. BOYD, M.D.,AND ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-573-8555
Mailing Address - Street 1:969 W MAIN ST
Mailing Address - Street 2:2D
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2653
Mailing Address - Country:US
Mailing Address - Phone:203-573-8555
Mailing Address - Fax:203-597-9565
Practice Address - Street 1:969 W MAIN ST
Practice Address - Street 2:2D
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2653
Practice Address - Country:US
Practice Address - Phone:203-573-8555
Practice Address - Fax:203-597-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0025181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800000440Medicare UPIN