Provider Demographics
NPI:1730277088
Name:BEGELMAN, DAVID A (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:BEGELMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-5303
Mailing Address - Country:US
Mailing Address - Phone:860-355-1869
Mailing Address - Fax:860-354-8564
Practice Address - Street 1:219 KENT RD
Practice Address - Street 2:SUITE 14
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-5528
Practice Address - Country:US
Practice Address - Phone:860-355-1869
Practice Address - Fax:860-354-8564
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000343103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist