Provider Demographics
NPI:1912100793
Name:FOX, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 OLD NEW MILFORD RD
Mailing Address - Street 2:STE 1 E
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2426
Mailing Address - Country:US
Mailing Address - Phone:203-775-9711
Mailing Address - Fax:203-740-8890
Practice Address - Street 1:2 OLD NEW MILFORD RD
Practice Address - Street 2:STE 1 E
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2426
Practice Address - Country:US
Practice Address - Phone:203-775-9711
Practice Address - Fax:203-740-8890
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029514102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst