SPECTRUM BEHAVIORAL PC (NPI# 1457636383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457636383 |
| Entity Type | Organization |
| Organization Name | SPECTRUM BEHAVIORAL PC |
| Practice Address |
30 Buxton Farm Rd Suite140 Stamford CT 06905-1224 |
| Practice Telephone | 2036127512 |
| Practice Fax Number | 2039303655 |
| Mailing Telephone | 2036127512 |
| Mailing Fax Number | 2039303655 |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2012-01-30 |
| Authorized Official Name | DR. SUNIL SAXENA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2036127511 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC1900X |
Psychologist Specialization: Counseling |
3117 | CT | Behavioral Health & Social Service Providers |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
043723 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
30 BUXTON FARM RD SUITE140 |
| City | STAMFORD |
| State | CT |
| Zip Code | 06905-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982769600 | Soohyun Nam | Nurse Practitioner | 30 Buxton Farm Rd, Stamford, CT 06905 | 2006-12-22 |
| 1043874076 | Alexandra Van Duyne | Behavioral Analyst | 30 Buxton Farm Rd, Stamford, CT 06905-1224 | 2019-04-25 |
| 1457823916 | Evangelina Baez | Behavioral Analyst | 30 Buxton Farm Rd, Stamford, CT 06905-1224 | 2018-12-21 |
| 1144725656 | Kempton Brisport | Social Worker | 30 Buxton Farm Rd, Stamford, CT 06905-1224 | 2018-03-27 |
| 1205331618 | Christy Jean Lanieri | Occupational Therapist | 30 Buxton Farm Rd, Stamford, CT 06905-1224 | 2018-03-27 |
| 1760986079 | Tajhma Dashawn Burroughs | Occupational Therapist | 30 Buxton Farm Rd, Suite 230, Stamford, CT 06905 | 2018-03-21 |
| 1437659646 | Diane Zettergren | Occupational Therapist | 30 Buxton Farm Rd, Suite #230, Stamford, CT 06905 | 2018-02-14 |
| 1831606615 | Megan Micola | Physical Therapist | 30 Buxton Farm Rd, Suite #230, Stamford, CT 06905 | 2018-01-03 |
| 1457877417 | Kelly Pombo | Physical Therapist | 30 Buxton Farm Rd, Suite 230, Stamford, CT 06905 | 2017-08-21 |
| 1770009722 | Juana Torres | Occupational Therapy Assistant | 30 Buxton Farm Rd, Suite 230, Stamford, CT 06905 | 2017-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
| 1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
| 1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
| 1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
| 1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
| 1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
| 1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
| 1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
| 1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
| 1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
| Find all providers in zip 06905 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649667106 | Ayodola Adigun | Psychiatry & Neurology | 200 Broad St Apt 2214, Stamford, CT 06901-2070 | 2015-04-22 |
| 1902394208 | Aaron J. Roberto, M.d., L.L.C. | Psychiatry & Neurology | 28 1st St, Stamford, CT 06905-5101 | 2018-04-23 |
| 1659614279 | Comprehensive Psychiatric Solutions LLC | Psychiatry & Neurology | 666 Glenbrook Rd Ste 1, Stamford, CT 06906-1439 | 2013-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801209952 | Oscar A Gerdner | Psychiatry & Neurology | 167 Old Post Rd, Southport, CT 06890-1395 | 2014-06-06 |
| 1194165720 | H and B Quality Medical Care LLC | Psychiatry & Neurology | 2 Ivy Brook Rd Ste 120, Shelton, CT 06484-6416 | 2013-06-27 |
| 1659710242 | Ibrahim N. Orgun | Psychiatry & Neurology | 44 Craigemore Cir, Avon, CT 06001-3417 | 2013-06-18 |
| 1588007314 | Avery Grauer | Psychiatry & Neurology | 175 Copse Road, Madison, CT 06443 | 2013-04-11 |
| 1972864627 | Sandra Boltax-stern, Md, PC | Psychiatry & Neurology | 78 Ansonia Road, Woodbridge, CT 06525 | 2012-05-30 |
| 1689972382 | Satwant Ahluwalia | Psychiatry & Neurology | 13 Woods Way, Redding, CT 06896-3200 | 2011-03-03 |
| 1962647842 | Pamela Edie Hoffman | Psychiatry & Neurology | 230 S Frontage Rd # G112, New Haven, CT 06519-1124 | 2008-12-08 |
| 1649423567 | Susan Jane Finkelstein | Psychiatry & Neurology | 3 Sylvan Road South, Westport, CT 06880 | 2008-10-23 |
| 1205083359 | Robert Khalil | Psychiatry & Neurology | 7 Old Sherman Tpke Ste 102, Danbury, CT 06810-4174 | 2008-08-20 |
| 1881850360 | Jason Velasco | Psychiatry & Neurology | 87 West St, Danbury, CT 06810-6528 | 2008-08-04 |
| Find all providers with the same taxonomy | ||||
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| 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.