Mark Goldenberg, DC

Individual provider Active NPI Neurology Chiropractor · Weston, CT

NPI 1508196197 · NPPES record last updated Jan 5, 2010

Key facts

NPI
1508196197
Entity type
Individual (NPI type 1)
Primary specialty
Neurology Chiropractor 111NN0400X
License
529 (CT)
Practice address
38 Old Orchard Dr
Weston, CT 06883-1309
Phone
(203) 557-3014
NPI assigned
Jan 5, 2010
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

State licenses

LicenseStateTypeSpecialty
529CTMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 529 CT Yes

Addresses

Primary practice location

38 Old Orchard Dr
Weston, CT 06883-1309

Mailing address

38 Old Orchard Dr
Weston, CT 06883-1309

Other providers in Weston, CT

All providers in Weston, CT · Neurology Chiropractor in Connecticut

Sources for this page

Verify at the official NPI Registry.