THEODORE HENDRICKSON
NPI 1699336073
Nurse Practitioner - Psychiatric/Mental Health in Fairfield, CT
Active since June 26, 2019
About Theodore Hendrickson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THEODORE HENDRICKSON (NPI 1699336073) is an individual psychiatric/mental health provider in Fairfield, Connecticut, licensed in Connecticut (102729) and active in the NPI registry since June 2019.
NPPES Registry Identity
NPI1699336073
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameTHEODORE HENDRICKSON
Location Address43 ROBERT LNFairfield, CT 06824-2918
Mailing Address43 Robert LnFairfield, CT 06824-2918 · (203) 209-2180
Phone(203) 209-2180
Sole ProprietorNo
Enumeration DateJune 26, 2019
✔ NPI 1699336073 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CT · 102729
43 ROBERT LN, Fairfield, CT 06824
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699336073, enumerated as an "individual" on June 26, 2019.
The provider is located at 43 ROBERT LN FAIRFIELD, CT 06824 and the phone number is (203) 209-2180.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
