Provider Demographics
NPI: | 1114374196 |
---|---|
Name: | ARNON BEN-YOSEPH |
Entity type: | Organization |
Organization Name: | ARNON BEN-YOSEPH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL PSYCHOLOGIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ARNON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BEN-YOSEPH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSYD |
Authorized Official - Phone: | 203-456-4730 |
Mailing Address - Street 1: | 53 WARWICK RD |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW FAIRFIELD |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06812-3130 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 203-456-4730 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 53 WARWICK RD |
Practice Address - Street 2: | |
Practice Address - City: | NEW FAIRFIELD |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06812-3130 |
Practice Address - Country: | US |
Practice Address - Phone: | 203-456-4730 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-05-19 |
Last Update Date: | 2016-05-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CT | 003548 | 103TC0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Single Specialty |