Basil Anton, PH.D.

Individual provider Active NPI Clinical Psychologist · Cheshire, CT

NPI 1063563377 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063563377
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
001366 (CT)
Practice address
908 S Meriden Rd
Cheshire, CT 06410-1863
Phone
(203) 272-0353
Fax
(203) 271-3243
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001366CTMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001366 CT Yes

Addresses

Primary practice location

908 S Meriden Rd
Cheshire, CT 06410-1863

Mailing address

908 S Meriden Rd
Cheshire, CT 06410-1863
Phone (203) 272-0353

Other providers in Cheshire, CT

All providers in Cheshire, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.