Provider Demographics
NPI:1104871086
Name:DAYTON, GARY WILLIAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:WILLIAM
Last Name:DAYTON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MINNECHAUG DR
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1909
Mailing Address - Country:US
Mailing Address - Phone:860-432-0561
Mailing Address - Fax:860-432-0561
Practice Address - Street 1:65 MINNECHAUG DR
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1909
Practice Address - Country:US
Practice Address - Phone:860-432-0561
Practice Address - Fax:860-432-0561
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002812103TC0700X
NY016654-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical