State of Connecticut
NPI #1720013360 in Bridgeport, Connecticut
Provider Information
- NPI Number
- 1720013360
- Entity Type
- Organization
- Organization Name
- State of Connecticut
- Primary Specialty
- Psychiatric Hospital
- Enumeration Date
- Jul 12, 2006
- Last Updated
- Mar 16, 2016
Practice Location
- Address
- 1635 CENTRAL AVE
- City
- Bridgeport
- State
- Connecticut
- ZIP Code
- 06610
- Phone
- (203) 551-7660
Authorized Official
- Name
- MR. STEPHEN A DIPIETRO
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (860) 418-6923
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Hospital |
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