Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TA0700X | Adult Development & Aging Psychologist |
NPI | 1669792297 |
---|---|
Provider Name | Louis G Tufano |
First Address | Wolcott, CT 06716-2626 |
Second Address | Wolcott, CT 06716-2626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2010 |
Last Update Date | 05/06/2010 |