Provider Demographics
NPI:1801951561
Name:CITRIN, ROBERT BRUCE (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:CITRIN
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 1:1700 POST RD
Mailing Address - Street 2:SUITE C-18
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5795
Mailing Address - Country:US
Mailing Address - Phone:203-254-3800
Mailing Address - Fax:
Practice Address - Street 1:1700 POST RD
Practice Address - Street 2:SUITE C-18
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5795
Practice Address - Country:US
Practice Address - Phone:203-254-3800
Practice Address - Fax:203-254-7062
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1062103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist