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BRUCE A. BERLOW M.D.
>> Specialist >> Other Service ProvidersRegistrant NPI Number: 1720065154
Individual Registrant: BRUCE A. BERLOW M.D.
Gender: M
Gender: M
Location and contact information for practice:
23 CLARA DR SUITE 204 MYSTIC, CT 06355-1959 US
Tel: 860-536-2995 Fax: 860-572-0265
Tel: 860-536-2995 Fax: 860-572-0265
Contact information for business:
23 CLARA DR SUITE 204 MYSTIC, CT 06355-1959 US
Tel: 860-536-2995 Fax: 860-572-0265
Tel: 860-536-2995 Fax: 860-572-0265
Registration Information:
NPI: 1720065154
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 174400000X | Other Service Providers Specialist | CT | 036951 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
