Provider Demographics
NPI:1740321892
Name:CREAL, ROBERT S (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:CREAL
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 1:132 STILSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-5440
Mailing Address - Country:US
Mailing Address - Phone:860-354-0150
Mailing Address - Fax:
Practice Address - Street 1:36 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2830
Practice Address - Country:US
Practice Address - Phone:860-354-5116
Practice Address - Fax:860-350-2189
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000964103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080263OtherMANAGED HEALTH NETWORK
CT116711OtherVALUE OPTIONS
CT58378OtherCONNECTICARE-UNITED BEHAV
CTP2742452OtherOXFORD
CT204167OtherCOMPSYCH
CT0005680748OtherAETNA