Brian D Kiluk, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

003121 Issued in CT

Practice address

1 Long Wharf Dr
Substance Abuse Treatment Unit (Satu)
New Haven, CT 06511-5991

Phone

(203) 974-5736

Fax

(203) 974-5790

NPI assigned

Mar 21, 2013

Last updated

Mar 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Connecticut

  dba Connecticut Mental Health Center

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1568704104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "SUBSTANCE ABUSE TREATMENT UNIT (SATU)",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-974-5736",
            "fax_number": "203-974-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "SUBSTANCE ABUSE TREATMENT UNIT (SATU)",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-974-5736",
            "fax_number": "203-974-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILUK",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003121",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Kilcoyne, PHARMD.
• Brigid Kelley Killelea, M.D.
• Bryce Killingsworth, MD
• John Perry Killion, MD
• Stephanie Marcella Kilpatrick, PSY.D.
• Robin Kim Lovecchio
• Alexander Taehoon Kim, MD
• Chungsoo Kim, PHARMD, PHD
• Daniel E Kim, M.D.
• Donald Ho Kim, MD

• Psychologist in New Haven, CT
• Providers in New Haven, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.