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DR. MATTHEW M. BURG PHD
Clinical >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1508976721
Individual Registrant:DR. MATTHEW M. BURG PHD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
81 GREEN HILL RD MADISON, CT 06443-2161 US
Tel: 203-245-1628 Fax: 203-245-5759
Tel: 203-245-1628 Fax: 203-245-5759
Contact information for business:
81 GREEN HILL RD MADISON, CT 06443-2161 US
Tel: 203-245-1628 Fax: 203-245-5759
Tel: 203-245-1628 Fax: 203-245-5759
Registration Information:
NPI: 1508976721
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| X | 103TC0700X | Behavioral Health & Social Service Providers Psychologist Clinical | CT | 1422 |
| X | 103TH0100X | Behavioral Health & Social Service Providers Psychologist | CT | 1422 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
