BRUCE A. BERLOW (NPI# 1720065154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720065154 |
| Entity Type | Individual |
| Full Name | BRUCE A. BERLOW |
| Credential | M.D. |
| Practice Address |
23 Clara Dr Suite 204 Mystic CT 06355-1959 |
| Practice Telephone | 8605362995 |
| Practice Fax Number | 8605720265 |
| Mailing Telephone | 8605362995 |
| Mailing Fax Number | 8605720265 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036951 | CT | Other Service Providers |
| Street Address |
23 CLARA DR SUITE 204 |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355-1959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316924749 | Doron J Ber | Allergy & Immunology | 23 Clara Dr, Suite 204, Mystic, CT 06355-1959 | 2005-12-28 |
| 1528236932 | Gabrielle Eden Pierce | Physician Assistant | 23 Clara Dr, Suite 201, Mystic, CT 06355-1959 | 2008-02-19 |
| 1013195064 | Laura Ann White | Optometrist | 23 Clara Dr, Visions Sight and Learning Center, Mystic, CT 06355 | 2008-02-01 |
| 1003001850 | Main Medical-mystic, LLC | Internal Medicine | 23 Clara Dr, Suite 201, Mystic, CT 06355-1959 | 2007-09-13 |
| 1467659227 | Adrienne Lynne Marold Parad | Family Medicine | 23 Clara Dr, Suite 203, Mystic, CT 06355-1959 | 2007-06-27 |
| 1811109259 | Coastal Chiropractic & Family Wellness Centre | Chiropractor | 23 Clara Dr, Suite 105, Mystic, CT 06355-1959 | 2007-05-06 |
| 1942424551 | Mahesh Anil Netravali | Allergy & Immunology | 23 Clara Dr, Suite 204, Mystic, CT 06355-1959 | 2007-04-13 |
| 1265656946 | Jennifer Felicelli | Physician Assistant | 23 Clara Dr, Mystic, CT 06355-1959 | 2007-04-12 |
| 1558406066 | Daniel Leroy Waggoner | Allergy & Immunology | 23 Clara Dr, Suite 204, Mystic, CT 06355-1959 | 2007-02-21 |
| 1881757243 | Shoreline Allergy & Asthma Associates LLP | Allergy & Immunology | 23 Clara Dr, Suite 204, Mystic, CT 06355-1959 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063443422 | Henry B Freye | Specialist | 22 Elizabeth Ct, Mystic, CT 06355-3111 | 2006-07-05 |
| 1255542882 | Falck Eye Centers, L.L.C. | Specialist | 35 Washington St, Mystic, CT 06355-2816 | 2007-05-25 |
| 1487770228 | J. Andrew Hallberg, Md, LLC | Specialist | 56 Whitehall Ave, Suite A, Mystic, CT 06355-1967 | 2007-03-22 |
| 1811960750 | Beth Tannatt | Specialist | 2440 Gold Star Hwy, Mystic, CT 06355-1180 | 2006-02-10 |
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|---|---|---|---|---|
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| 1679103931 | Gail Joan Dalby | Specialist | 1360 Whitney Ave, Hamden, CT 06517-2400 | 2020-01-24 |
| 1982248902 | Tracy Cook | Specialist | 1533 New Britain Ave Ste 2, Farmington, CT 06032-3378 | 2019-11-02 |
| 1477106482 | Elevate Pt- Stamford Pllc | Specialist | 1234 Summer St Ste 102, Stamford, CT 06905-5558 | 2019-07-18 |
| 1598238321 | Amanda Andrade | Specialist | 40 Whippoorwill Rd, Bethel, CT 06801-2723 | 2019-01-03 |
| 1366921827 | Matt Dutton | Specialist | 1 Highpoint Ct, Woodbury, CT 06798-3228 | 2018-08-07 |
| 1013422591 | Connecticut Orthopaedic Specialists, PC | Specialist | 2499 Main St Ste 6, Stratford, CT 06615-5843 | 2017-12-06 |
| 1114430782 | Elevate Professional Services, LLC | Specialist | 19 Old Kings Hwy S Ste 120, Darien, CT 06820-4532 | 2017-11-06 |
| 1417476052 | Lauri Weil | Specialist | 104 Old Washington Rd, Ridgefield, CT 06877-5918 | 2017-09-14 |
| 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.