CONNECTICUT NEURODEVELOPMENTAL SERVICES (NPI# 1467527580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467527580 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT NEURODEVELOPMENTAL SERVICES |
| Practice Address |
134 Grandview Ave Waterbury CT 06708-2507 |
| Mailing Address |
134 Grandview Ave Suite# 208 Waterbury CT 06708-2507 |
| Practice Telephone | 2037553279 |
| Practice Fax Number | 2037553057 |
| Mailing Telephone | 2037553279 |
| Mailing Fax Number | 2037553057 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2013-09-30 |
| Authorized Official Name | ALOK BHARGAVA (OWNER) |
| Authorized Official Telephone | 2037553279 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
030847 | CT | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 030847 | CT | Allopathic & Osteopathic Physicians |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
003467 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
003467 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
004478 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
004478 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
030847 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
134 GRANDVIEW AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114928827 | Specialists In Women's Healthcare PC | Advanced Practice Midwife | 134 Grandview Ave, Ste 210, Waterbury, CT 06708-2507 | 2005-08-03 |
| 1245714567 | Barbara Rymer | Nurse Practitioner | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2018-09-21 |
| 1407120751 | Vanessa Daou | Advanced Practice Midwife | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2012-03-05 |
| 1205144300 | Daniel P Baxter | Physician Assistant | 134 Grandview Ave, Suite 101, Waterbury, CT 06708-2507 | 2010-09-23 |
| 1811204985 | Kathleen Lea Sullivan | Nurse Practitioner | 134 Grandview Ave, 208, Waterbury, CT 06708-2507 | 2010-09-09 |
| 1114232832 | Theresa F Piliero | Nurse Practitioner | 134 Grandview Ave, Suite 202, Waterbury, CT 06708-2507 | 2010-08-18 |
| 1194956045 | Kristen D Graff Beardslee | Advanced Practice Midwife | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2009-07-27 |
| 1922245745 | Kelly Lynn Palmer | Occupational Therapist | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2009-01-15 |
| 1548423973 | Jenna A Logiudice | Obstetrics & Gynecology | 134 Grandview Ave, Suite 210, Waterbury, CT 06708-2507 | 2008-07-07 |
| 1285821603 | Cybill Shelby Thomas | Nurse Practitioner | 134 Grandview Ave, Waterbury, CT 06708-2507 | 2007-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early 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 |
|---|---|---|---|---|
| 1750583399 | Amanda W Pong | Psychiatry & Neurology | 50 Forest St, Apt 1421, Stamford, CT 06901 | 2007-06-05 |
| 1023158904 | Kathryn A Mcvicar | Psychiatry & Neurology | 330 Cedar St # Lmp3088, Yale Medical Pediatric Neurology, New Haven, CT 06510-3218 | 2007-02-08 |
| 1891701918 | Robert Louis Cerciello | Psychiatry & Neurology | 1001 Farmington Avenue, Ste 301, West Hartford, CT 06107-2121 | 2006-07-31 |
| 1750321428 | Azimuddin Kazi | Psychiatry & Neurology | 2590 Main St, Stratford, CT 06615-5838 | 2006-06-08 |
| 1801215561 | Shilpa Dass | Psychiatry & Neurology | 1 Park St, New Haven, CT 06504-8901 | 2014-04-09 |
| 1053656892 | Linda Lee Huh | Psychiatry & Neurology | 800 Howard Ave, New Haven, CT 06519-1369 | 2012-12-05 |
| 1356611875 | Lila Worden | Psychiatry & Neurology | 282 Washington St, Hartford, CT 06106-3322 | 2012-01-02 |
| 1508182767 | Vinita Knight | Psychiatry & Neurology | 333 Cedar St, Lmp 3088, New Haven, CT 06510-3206 | 2010-04-13 |
| 1134352263 | Robert L. Cercietto, M.d., P.C. | Psychiatry & Neurology | 1001 Farmington Avenue, Suite #301, West Hartford, CT 06107-2121 | 2009-08-24 |
| 1356503585 | Mark Linderman Schomer | Psychiatry & Neurology | 282 Washington St, Hartford, CT 06106-3322 | 2008-06-30 |
| 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.