DOUGLAS DUFORE (NPI# 1174607113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174607113 |
| Entity Type | Individual |
| Full Name | DOUGLAS DUFORE |
| Credential | PHD |
| Practice Address |
633 Middlesex Tpke Suite 110 Old Saybrook CT 06475-1220 |
| Practice Telephone | 8605100225 |
| Practice Fax Number | 8603951647 |
| Mailing Telephone | 8605100225 |
| Mailing Fax Number | 8603951647 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-09-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
002793 | CT | Behavioral Health & Social Service Providers |
| Street Address |
633 MIDDLESEX TPKE SUITE 110 |
| City | OLD SAYBROOK |
| State | CT |
| Zip Code | 06475-1220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903256 | John H Fidler IIi | Physical Therapist | 633 Middlesex Tpke, Old Saybrook, CT 06475-1220 | 2020-08-18 |
| 1295393064 | Chad Porterfield | Pharmacist | 633 Middlesex Tpke, Old Saybrook, CT 06475-1220 | 2019-06-05 |
| 1457797755 | Charles A. Odonkor | Anesthesiology | 633 Middlesex Tpke, Old Saybrook, CT 06475 | 2013-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912464223 | Kathleen Malcolm | Physical Medicine & Rehabilitation | Apple Rehab Saybrook, 1775 Boston Post Rd, Old Saybrook, CT 06475 | 2019-02-22 |
| 1841661469 | Laura M. Shires, Lcsw, LLC | Social Worker | 24 Ledge Road, Old Saybrook, CT 06475 | 2015-10-08 |
| 1316323397 | Robyn Reilly | Nurse Practitioner | 1687 Rte 1, Old Saybrook, CT 06475 | 2015-08-03 |
| 1679858542 | Brandi Taylor | Counselor | 263 Main St., Suite 301, Old Saybrook, CT 06475 | 2011-10-11 |
| 1346545670 | Lucille Wymer Hartman | Mechanotherapist | 1775 Boston Post Road, Old Saybrook, CT 06475 | 2011-01-18 |
| 1508160631 | Whole Health Wellness, LLC | Clinic/Center | 139 Mill Rock Rd E Unit 1522, Old Saybrook, CT 06475 | 2011-01-04 |
| 1184948481 | Maria S. Foss-rand | Counselor | 251 Main St., Suite 100, Old Seybrook, CT 06475 | 2010-03-16 |
| 1467658161 | Rick Morant Dmd Ms LLC | Dentist | 1358 Boston Post Rd, Suite 2, Old Saybrook, CT 06475 | 2007-06-21 |
| 1174724801 | Richard P Benoit Dmd PC | Dentist | 123 Elm Street, Suite 1300, Old Saybrook, CT 06475 | 2007-05-30 |
| 1194932392 | Omotayo Elizabeth Awujoola | Nurse Practitioner | 20 Research Parkway, Old Saybrook, CT 06475 | 2007-05-17 |
| Find all providers in zip 06475 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336334614 | Kathleen C. Laundy Associates, LLC | Psychologist | 954 Middlesex Tpke Ste A-2, Old Saybrook, CT 06475-1349 | 2007-09-11 |
| 1982628020 | Karl E Scheibe | Psychologist | 841 Middlesex Tpke, Old Saybrook, CT 06475-1317 | 2006-07-26 |
| 1518963784 | Gary M Freudenthal | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2005-06-22 |
| 1053760579 | Marguerite Ruppenicker | Psychologist | 49 Sherwood Ter, Basement Level, Old Saybrook, CT 06475-2123 | 2016-06-06 |
| 1407237027 | Noel Quinn | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2015-06-10 |
| 1609256478 | Medoptions of Virginia LLC | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2015-06-05 |
| 1528347556 | Debra P. Hauser | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2011-08-09 |
| 1285912550 | Maggie Black | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2011-08-03 |
| 1104118967 | Carla Ratti | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2011-05-11 |
| 1760704241 | Tracy E. Ransom | Psychologist | 20 Research Pkwy, Old Saybrook, CT 06475-4214 | 2010-02-24 |
| Find all providers in OLD SAYBROOK | ||||
| City | OLD SAYBROOK |
| Zip Code | 06475 |
Please comment or provide details below to improve the information on DOUGLAS DUFORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.