Provider Demographics
NPI:1669792297
Name:TUFANO, LOUIS G (PHD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:G
Last Name:TUFANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 WOLCOTT RD
Mailing Address - Street 2:GERICARE
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2626
Mailing Address - Country:US
Mailing Address - Phone:203-633-4560
Mailing Address - Fax:
Practice Address - Street 1:464 WOLCOTT RD
Practice Address - Street 2:GERICARE
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2626
Practice Address - Country:US
Practice Address - Phone:203-633-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging