Search › Connecticut › 101YA0400X
Doug Gruber, LADC
NPI 1992076780 · on the registry since 2012
Practice
- Address
- 466 W Main St
Waterbury, CT 06702 - Phone
- (203) 591-8010
- Fax
- (203) 591-8586
- Organisation at this address
- Connecticut Renaissance, Inc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 101YM0800X
- Licence states on file
- CT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-01-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Connecticut